Individual
MRS. MICHELE CARLA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.S.W.
Contact information
Practice address
6759 N RAVENSWOOD AVE, CHICAGO, IL 60626-3928
(773) 301-5257
Mailing address
315 HAWTHORN AVE APT D, GLENCOE, IL 60022-1624
(847) 835-5637
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150006366
IL
Other
Enumeration date
11/12/2007
Last updated
11/12/2007
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