Anita Johanson Maddox, LCPC
NPI #1770623407 in Lake Villa, Illinois
Provider Information
- NPI Number
- 1770623407
- Entity Type
- Individual
- Name
- Anita Johanson Maddox, LCPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Developmental Therapist
- Credential
- LCPC
- Enumeration Date
- Feb 8, 2007
- Last Updated
- Sep 21, 2010
Practice Location
- Address
- 89 CEDAR AVE
- City
- Lake Villa
- State
- Illinois
- ZIP Code
- 60046-8411
- Phone
- (847) 265-7300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Developmental Therapist |
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