Individual
JULIA GRACE TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1622 W COLUMBIA AVE APT 3N, CHICAGO, IL 60626-4160
(415) 420-8612
Mailing address
1157 W FARWELL AVE # 2E, CHICAGO, IL 60626-3809
(415) 420-8612
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
166.001410
IL
Other
Enumeration date
05/22/2008
Last updated
11/17/2020
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