Individual
NICOLE BRENNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5624 S MEADE AVE, CHICAGO, IL 60638-3504
(708) 259-3171
Mailing address
5624 S MEADE AVE, CHICAGO, IL 60638-3504
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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