Individual
MARISSA WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4635 LAWN AVE, SUITE 8, WESTERN SPRINGS, IL 60558-1554
(773) 888-2602
Mailing address
4365 LAWN AVE, SUITE 8, WESTERN SPRINGS, IL 60558-1465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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