Individual
ALBERTA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 W 79TH ST, CHICAGO, IL 60620-5723
(312) 757-0608
Mailing address
PO BOX 29282, CHICAGO, IL 60629-0282
(773) 431-6001
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.004350
IL
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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