Individual
JESSENIA BRISENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4058 W 63RD ST, CHICAGO, IL 60629-4639
(773) 584-6200
Mailing address
2304 S SAINT LOUIS AVE, CHICAGO, IL 60623-3144
(773) 320-7381
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.105615
IL
Other
Enumeration date
01/06/2023
Last updated
02/08/2023
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