Individual
CARLOS A SAMANIEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1653 W 35TH ST, CHICAGO, IL 60609-1309
(773) 426-8054
Mailing address
3703 S DAMEN AVE, CHICAGO, IL 60609-1117
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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