Organization
BRAVE SPACE COUNSELING & CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA CASTILLO (OWNER)
(773) 490-7900
Entity
Organization
Contact information
Practice address
2950 W CHICAGO AVE, CHICAGO, IL 60622-4375
(312) 834-3490
Mailing address
433 W HARRISON ST # 8578, CHICAGO, IL 60699-3916
(773) 490-7900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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