Individual
MS. BRYN ANNE POULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1103 WESTGATE ST STE 205, OAK PARK, IL 60301-1022
(773) 852-6898
Mailing address
1103 WESTGATE ST STE 205, OAK PARK, IL 60301-1022
(773) 852-6898
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-009823
IL
Other
Enumeration date
08/06/2007
Last updated
02/26/2020
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