NPI Profile for KEVIN CONNOLLY in BLOOMINGDALE, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Marriage & Family Therapist |
106H00000X | |||
Mental Health |
101YM0800X |
| NPI Number | 1124419643 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/06/2015 | |
| Last updated | 02/12/2015 - About 11 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KEVIN CONNOLLY
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