Organization
GERIATRIC THERAPY SPECIALIST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYSON BLASIUS LCSW (LCSW)
(773) 960-7919
Entity
Organization
Contact information
Practice address
133 N HUMPHREY AVE, OAK PARK, IL 60302-2513
(774) 960-7919
Mailing address
133 N HUMPHREY AVE, OAK PARK, IL 60302-2513
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
149.013000
IL
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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