Individual
TALIA CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10840 S FOREST AVE, CHICAGO, IL 60628-3613
(773) 407-5543
Mailing address
10840 S FOREST AVE, CHICAGO, IL 60628-3613
(773) 407-5543
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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