Individual
MS. BONITA RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1300 W DEVON AVE, CHICAGO, IL 60660-1302
(773) 751-7850
(773) 751-7855
Mailing address
1300 W DEVON AVE, CHICAGO, IL 60660-1302
(773) 751-7850
(773) 751-7855
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.020950
IL
Other
Enumeration date
10/07/2019
Last updated
01/09/2020
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