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1306399944
SANDRA ELIZABETH DOMICO
EVANSTON, IL
NPI
1306399944
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.018069)
Enumeration Date
2016-08-01
Last Update Date
2016-08-01
Business Address
Ms. SANDRA ELIZABETH DOMICO LCSW
355 RIDGE AVE 2ND FLOOR
EVANSTON, IL 60202-3328
Phone number: 847-316-6262
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Mailing Address
Ms. SANDRA ELIZABETH DOMICO LCSW
1623 W FARGO AVE 1
CHICAGO, IL 60626-1771
Phone number: 773-597-5187
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