Individual
AISHA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1029 E 130TH ST, CHICAGO, IL 60628-6908
(773) 995-6300
Mailing address
1029 E 130TH ST, CHICAGO, IL 60628-6908
(773) 995-6300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
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