MS. Mary Susan Fidale, LCPC, RNC
NPI #1023467420 in Long Grove, Illinois
Provider Information
- NPI Number
- 1023467420
- Entity Type
- Individual
- Name
- MS. Mary Susan Fidale, LCPC, RNC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Credential
- LCPC, RNC
- Enumeration Date
- Jun 7, 2016
- Last Updated
- Jun 7, 2016
Practice Location
- Address
- 4160 RT 83 SUITE 206
- City
- Long Grove
- State
- Illinois
- ZIP Code
- 60047-9585
- Phone
- (847) 217-6190
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Registered Nurse |
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