Individual
AYESHA SCONYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.A
Contact information
Practice address
9204 S ELLIS AVE, CHICAGO, IL 60619-7825
(224) 423-7552
Mailing address
9204 S ELLIS AVE, CHICAGO, IL 60619-7825
(224) 423-7552
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
NONE
—
Enumeration date
06/06/2020
Last updated
06/06/2020
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