Individual
IESHA MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2912 224TH ST, SAUK VILLAGE, IL 60411-5804
(708) 295-2942
Mailing address
2912 224TH ST, SAUK VILLAGE, IL 60411-5804
(708) 295-2942
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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