Individual
ALEXANDRIA CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1945 W WILSON AVE # 5108, CHICAGO, IL 60640-5255
(312) 298-9104
Mailing address
1357 W BERWYN AVE APT 1, CHICAGO, IL 60640-2275
(734) 664-1596
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.018616
IL
Other
Enumeration date
10/16/2017
Last updated
08/05/2021
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