Individual
ELLEN M WOODHAM-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5320 159TH ST STE 100, OAK FOREST, IL 60452-3329
(708) 381-5009
Mailing address
PO BOX 764, MANTENO, IL 60950-0764
(708) 381-5009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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