Individual
AMANDA JEAN IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4765 N LINCOLN AVE STE 208, CHICAGO, IL 60625-2077
(872) 302-3396
Mailing address
4680 N KASSON AVE UNIT 2, CHICAGO, IL 60630-4230
(872) 302-3396
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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