Individual
KEZIA ODAMTTEN MANTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
(847) 984-5676
Mailing address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
(847) 984-5676
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IL
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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