Individual
ETHAN EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1422 W LUNT AVE APT 2N, CHICAGO, IL 60626-2843
(781) 248-9656
Mailing address
1422 W LUNT AVE APT 2N, CHICAGO, IL 60626-2843
(781) 248-9656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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