NPI 1255475612 · live from the CMS NPI Registry
Penelope Sue Whitaker Booher, M.A.
Marriage & Family Therapist in Yorkville, IL. National Provider Identifier 1255475612, active.
NPI record
| NPI | 1255475612 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 811 W John St, Yorkville, IL 60560 |
| Practice phone | 630-553-9100 |
| Enumerated | February 19, 2007 |
| Last updated | March 31, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | 11085 (TX) |
| Marriage & Family Therapist | 106H00000X | 2244 (TX) |
| Marriage & Family Therapist primary | 106H00000X | 166.000704 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.