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1578668794
MICHAEL TODD PUCKETT
CHICAGO, IL
NPI
1578668794
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180005699)
Enumeration Date
2006-09-13
Last Update Date
2007-07-08
Business Address
Mr. MICHAEL TODD PUCKETT LCPC
980 N MICHIGAN AVE STE 1400
CHICAGO, IL 60611-7500
Phone number: 312-214-3588
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Mailing Address
Mr. MICHAEL TODD PUCKETT LCPC
1340 N ASTOR ST APT 2305
CHICAGO, IL 60610-2163
Phone number: 312-399-6862
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