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Ms. Tracey Latonya Blackburn
Mental Health Counselor in Des Plaines, Illinois
NPI 1629551304

Tracey Latonya Blackburn is a Mental Health Counselor based in Chicago, IL and is specialized in Mental Health. Tracey Latonya Blackburn practices in Des Plaines, IL. The NPI Number for Tracey Latonya Blackburn is 1629551304 and holds a License No. (Illinois).

The current practice location address for Tracey Latonya Blackburn is 1717 Rand Rd, Des Plaines, IL and can be reached out via phone at 773-294-5797.

Location: 1717 Rand Rd, Des Plaines, IL, 60622-1161
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629551304
Provider Name
Tracey Latonya Blackburn
Credential
Provider Entity Type
Individual
Gender
Female
Address
1717 Rand Rd, Des Plaines, IL, 60622-1161
Phone Number
773-294-5797
Fax Number
Provider Enumeration Date
09/10/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
362170821061 05 IL
institution
Provider Business Practice Location Address Details
Address
1717 Rand Rd
City
Des Plaines
State
Illinois
Zip
60016-3509
Phone Number
773-294-5797
Fax Number
person
Provider Business Mailing Address Details
Address
1717 Rand Rd
City
Des Plaines
State
Illinois
Zip
60016-3509
Phone Number
773-294-5797
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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