Individual
MRS. AMANDA LYNN BERBAUM AUSSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
84 S STONINGTON DR, PALATINE, IL 60074-6801
(847) 507-9823
Mailing address
5017 W BERTEAU AVE, CHICAGO, IL 60641-1738
(847) 507-9823
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149010168
IL
Other
Enumeration date
08/03/2019
Last updated
08/05/2020
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