Individual
MS. AGATHA MOELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1230 N STATE PKWY, #27C, CHICAGO, IL 60610-2260
(312) 932-9163
Mailing address
1967 N DAYTON ST, CHICAGO, IL 60614-5030
(312) 932-9163
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.006303
IL
Other
Enumeration date
12/27/2010
Last updated
12/27/2010
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