Individual
MRS. JAKKIA NAILAH LASHAWN SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
12257 S CARPENTER ST, CHICAGO, IL 60643-5503
(773) 577-6960
Mailing address
12257 S CARPENTER ST, CHICAGO, IL 60643-5503
(773) 577-6960
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178011129
IL
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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