Individual
MR. GLEN SEKOU FONDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
Mailing address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104100000X
IL
Other
Enumeration date
12/07/2011
Last updated
09/17/2024
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