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Individual

ALETHEA GOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
811 W EVERGREEN AVE STE 404, CHICAGO, IL 60642-7113
(312) 242-1665
Mailing address
917 N FAIRFIELD AVE # 3, CHICAGO, IL 60622-4454
(815) 501-7861

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149017983
IL

Other

Enumeration date
04/13/2017
Last updated
04/13/2017
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