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Individual

DESTINY ARIAL PATE CROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
55 E LOOP RD # 301A, WHEATON, IL 60189-1938
(630) 428-7890
Mailing address
1743 MCCORMICK LN, HANOVER PARK, IL 60133-5999
(630) 991-8918

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150108096
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113228431
IL
Enumeration date
05/13/2021
Last updated
09/16/2024
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