Individual
SANDRA MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1607 W HOWARD ST, 3 FL, CHICAGO, IL 60626-1675
(312) 744-7617
Mailing address
1607 W HOWARD ST, 3 FL, CHICAGO, IL 60626-1675
(312) 744-7617
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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