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MR. ANTHONY MODONI HEARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2021 N KEDZIE AVE APT 3C, CHICAGO, IL 60647-3786
(405) 627-0691
Mailing address
2021 N KEDZIE AVE APT 3C, CHICAGO, IL 60647-3786
(405) 627-0691

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149014744
IL

Other

Enumeration date
11/13/2011
Last updated
11/13/2011
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