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1255153391
THEODORA K GREEN
EVANSTON, IL
NPI
1255153391
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 150.111842)
Enumeration Date
2024-10-29
Last Update Date
2024-10-29
Business Address
Mrs. THEODORA K GREEN LSW, CADC RMA, DVA
825 CHICAGO AVE FL 2A
EVANSTON, IL 60202-2375
Phone number: 312-725-4088
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Mailing Address
Mrs. THEODORA K GREEN LSW, CADC RMA, DVA
7 SIMPSON ST # 1A
GENEVA, IL 60134-2459
Phone number: 312-725-4088
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