Individual
NICOLETTE ASHLEY AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1954 W IRVING PARK RD, CHICAGO, IL 60613-2408
(773) 414-4577
Mailing address
1954 W IRVING PARK RD, CHICAGO, IL 60613-2408
(773) 414-4577
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150105722
IL
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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