Individual
ASHLEY JANETTE TABATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MSW, LSW
Contact information
Practice address
39W492 S HYDE PARK, GENEVA, IL 60134-4924
(312) 415-9824
Mailing address
39W492 S HYDE PARK, GENEVA, IL 60134-4924
(312) 415-9824
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150111989
IL
Other
Enumeration date
11/21/2023
Last updated
01/05/2024
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