Individual
JACQUELINE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 W 27TH ST, APT 1, CHICAGO, IL 60616-2612
(639) 254-1849
Mailing address
312 W 27TH ST, APT 1, CHICAGO, IL 60616-2612
(639) 254-1849
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
129.008441
IL
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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