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1205377785
ROSE FERNANDEZ
CHICAGO, IL
NPI
1205377785
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL 18705)
Enumeration Date
2017-03-16
Last Update Date
2017-03-16
Business Address
-- ROSE FERNANDEZ CSADC - MISA 11
7124 W GRAND AVE
CHICAGO, IL 60707-2805
Phone number: 773-598-8540
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Mailing Address
-- ROSE FERNANDEZ CSADC - MISA 11
7124 W GRAND AVE
CHICAGO, IL 60707-2805
Phone number: 773-598-8540
Copy
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