Individual
CARLTHEL BRENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4137 SAUK TRL STE 116, RICHTON PARK, IL 60471-1253
(708) 634-6715
Mailing address
7601 LINDEN AVE, HAMMOND, IN 46324-3124
(708) 634-6715
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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