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1073156196
BLACK TIE THERAPY
CHICAGO, IL
NPI
1073156196
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Entity Type
Organization
Authorized Contact
MYRON NELSON
President
216-832-1907
Organization Subpart ?
No
Primary Taxonomy
251S00000X
Enumeration Date
2019-10-21
Last Update Date
2020-09-04
Business Address
BLACK TIE THERAPY
2232 N WAYNE AVE APT 1F
CHICAGO, IL 60614-8937
Phone number: 773-217-8426
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Mailing Address
BLACK TIE THERAPY
2232 N WAYNE AVE APT 1F
CHICAGO, IL 60614-8937
Phone number:
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