Individual
BRE'SHAE GRANDBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5801 N. PULASKI, CHICAGO, IL 60646
(312) 744-1906
Mailing address
12138 S THROOP ST, CHICAGO, IL 60643-5422
(773) 987-2942
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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