Provider Demographics
NPI:1881814978
Name:DUMLAO, MARY AMELIA (MA LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:AMELIA
Last Name:DUMLAO
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8280 KEARNEY RD
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516
Mailing Address - Country:US
Mailing Address - Phone:630-427-0995
Mailing Address - Fax:630-427-0997
Practice Address - Street 1:333 CHESTNUT
Practice Address - Street 2:SUITE 206
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60821
Practice Address - Country:US
Practice Address - Phone:630-850-9650
Practice Address - Fax:630-850-9607
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional