Provider Demographics
NPI:1093317109
Name:GUNTER-HARLAN, JENILLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:JENILLE
Middle Name:
Last Name:GUNTER-HARLAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 ROCKHURST RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2462
Mailing Address - Country:US
Mailing Address - Phone:630-461-6524
Mailing Address - Fax:
Practice Address - Street 1:190 LILY CACHE LN
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3415
Practice Address - Country:US
Practice Address - Phone:630-286-9770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health