Individual
DEZARAY LESLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
5529 W MONROE ST, CHICAGO, IL 60644-4053
(773) 750-2046
Mailing address
5529 W MONROE ST, CHICAGO, IL 60644-4053
(773) 750-2046
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.110336
IL
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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