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Individual

DR. DAMETRIA LYNN EWUNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
2930 S MICHIGAN AVE STE 100, CHICAGO, IL 60616
(773) 819-5504
Mailing address
2930 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-3484
(773) 819-5504

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
XXX
BCBS
Enumeration date
10/14/2019
Last updated
10/14/2019
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