Provider Demographics
NPI:1740499466
Name:BRESLER, DYANNE CYNTHIA (LCPC)
Entity type:Individual
Prefix:
First Name:DYANNE
Middle Name:CYNTHIA
Last Name:BRESLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4059
Mailing Address - Country:US
Mailing Address - Phone:847-692-6692
Mailing Address - Fax:888-440-2577
Practice Address - Street 1:36 MAIN ST
Practice Address - Street 2:106B
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4059
Practice Address - Country:US
Practice Address - Phone:847-692-6692
Practice Address - Fax:888-440-2577
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006486101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional