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Individual

MS. AMANDA COLLEEN SHANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2342 N JANSSEN AVE, CHICAGO, IL 60614-3020
(708) 903-0347
Mailing address
2342 N JANSSEN AVE, CHICAGO, IL 60614-3020
(708) 903-0347

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.020364
IL

Other

Enumeration date
12/06/2019
Last updated
12/06/2019
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