Individual
AUDREA F NANABRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1310 W 64TH ST, CHICAGO, IL 60636-2913
(773) 912-6967
(884) 778-9373
Mailing address
PO BOX 87421, CAROL STREAM, IL 60188-7421
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149019056
IL
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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