Individual
QUIANA MICHELLE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
579 W NORTH AVE STE 206, ELMHURST, IL 60126-2144
(630) 384-9499
(630) 324-4606
Mailing address
123 PARK ST, OSWEGO, IL 60543-9079
(773) 653-7890
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150110997
IL
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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