person
Charles S Miyamoto, REV;LPC
Professional Counselor in Evanston, Illinois
NPI 1508204066

Charles S Miyamoto is a Professional Counselor based in Evanston, IL and is specialized in Professional. Charles S Miyamoto practices in Evanston, IL and has the professional credentials of REV;LPC. The NPI Number for Charles S Miyamoto is 1508204066 and holds a License No. 178.008311 (Illinois).

The current practice location address for Charles S Miyamoto is 1427 Chicago Ave, Evanston, IL and can be reached out via phone at 847-864-9133.

Location: 1427 Chicago Ave, Evanston, IL, 60201-4726
person
Provider Profile Details
NPI Number
1508204066
Provider Name
Charles S Miyamoto
Credential
REV;LPC
Provider Entity Type
Individual
Gender
Male
Address
1427 Chicago Ave, Evanston, IL, 60201-4726
Phone Number
847-864-9133
Fax Number
Provider Enumeration Date
06/06/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1427 Chicago Ave
City
State
Zip
60201-4726
Phone Number
847-864-9133
Fax Number
person
Provider Business Mailing Address Details
Address
1427 Chicago Ave
City
State
Zip
60201-4726
Phone Number
847-864-9133
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
178.008311 (Illinois)
Definition
Definition to come...
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