Individual
DOMINIQUE MARBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 W CHICAGO AVE, CHICAGO, IL 60654-5600
(872) 777-8110
Mailing address
219 W CHICAGO AVE, CHICAGO, IL 60654-5600
(872) 777-7110
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.112440
IL
104100000X
Social Worker
—
—
Other
Enumeration date
11/10/2023
Last updated
03/26/2024
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