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Organization
MOVE THERAPY AND WELLNESS 1241 LLC
Active
Organization
MOVE THERAPY AND WELLNESS 1241 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MARIA ISABEL DZIEKIEWICZ LCSW (OWNER/PSYCHOTHERAPIST)
(312) 217-5887
Entity
Organization
Contact information
Practice address
3808 N ASHLAND AVE, COMMERCIAL CONDO, CHICAGO, IL 60613-5382
(312) 217-5887
Mailing address
3808 N ASHLAND AVE, COMMERCIAL CONDO, CHICAGO, IL 60613-5382
(312) 217-5887
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508105826
BCBS
IL
Enumeration date
09/17/2016
Last updated
09/17/2016
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