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1144785825
IDA J SAMUEL-CLAY
CHICAGO, IL
NPI
1144785825
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Former Name
IDA J SAMUEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180011416)
Enumeration Date
2019-02-06
Last Update Date
2019-02-06
Business Address
IDA J SAMUEL-CLAY LCPC
1136 S DELANO CT W STE B201
CHICAGO, IL 60605-3734
Phone number: 312-528-3234
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Mailing Address
IDA J SAMUEL-CLAY LCPC
8342 S PAXTON AVE
CHICAGO, IL 60617-1852
Phone number: 847-722-4074
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