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De'shace Short
Professional Counselor in Rockford, Illinois
NPI 1386429686

De'shace Short is a Professional Counselor based in Chicago, IL and is specialized in Professional. De'shace Short practices in Rockford, IL. The NPI Number for De'shace Short is 1386429686 and holds a License No. (Illinois).

The current practice location address for De'shace Short is 5758 Elaine Dr Ste 112, Rockford, IL and can be reached out via phone at 815-975-1177.

Location: 5758 Elaine Dr Ste 112, Rockford, IL, 60643-1537
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386429686
Provider Name
De'shace Short
Credential
Provider Entity Type
Individual
Gender
Female
Address
5758 Elaine Dr Ste 112, Rockford, IL, 60643-1537
Phone Number
815-975-1177
Fax Number
Provider Enumeration Date
08/28/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5758 Elaine Dr Ste 112
City
Rockford
State
Illinois
Zip
61108-3102
Phone Number
815-975-1177
Fax Number
person
Provider Business Mailing Address Details
Address
5758 Elaine Dr Ste 112
City
Rockford
State
Illinois
Zip
61108-3102
Phone Number
815-975-1177
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
(Illinois)
Definition
Definition to come...
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