Organization
DEFIANT GROWTH COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER MATTHEW LOZANO LCSW (LICENSED CLINICAL SOCIAL WORKER)
(312) 656-9786
Entity
Organization
Contact information
Practice address
2945 N SHEFFIELD AVE APT 1, CHICAGO, IL 60657-7483
(312) 656-9786
Mailing address
2945 N SHEFFIELD AVE APT 1, CHICAGO, IL 60657-7483
(312) 656-9786
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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