Individual
MS. AUDRA STOLZ MASTERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2740 W FOSTER AVE STE 113, CHICAGO, IL 60625-3547
(773) 293-5300
(773) 293-5346
Mailing address
2740 W FOSTER AVE STE 113, CHICAGO, IL 60625-3547
(773) 293-5300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
149018336
IL
1041C0700X
Clinical Social Worker
Primary
149.018336
IL
Other
Enumeration date
07/08/2019
Last updated
10/30/2020
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