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1134536865
MICHAEL MUDGETT
CHICAGO, IL
NPI
1134536865
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.018688)
Enumeration Date
2014-07-15
Last Update Date
2017-01-31
Business Address
-- MICHAEL MUDGETT LCSW
5524 W HARRISON ST
CHICAGO, IL 60644-5032
Phone number: 773-854-5073
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Mailing Address
-- MICHAEL MUDGETT LCSW
645 S CENTRAL AVE
CHICAGO, IL 60644-5059
Phone number:
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