Individual
MS. MARGARET HAZENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
3624 W 216TH ST, MATTESON, IL 60443-2713
(708) 481-4080
(708) 481-7725
Mailing address
3624 W 216TH ST, MATTESON, IL 60443-2713
(708) 481-4080
(708) 481-7725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149000030
IL
106H00000X
Marriage & Family Therapist
166000357
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636410
BCBS
—
Enumeration date
10/03/2006
Last updated
09/15/2010
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