C MARK MASSULLO

CHICAGO, IL
NPI1396969242
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149-007721)
Enumeration Date2007-04-12
Last Update Date2012-09-16
Business Address
-- C MARK MASSULLO LCSW
3166 N LINCOLN AVE 310
CHICAGO, IL 60657-3133
Phone number: 773-296-9876
Mailing Address
-- C MARK MASSULLO LCSW
3166 N LINCOLN AVE 310
CHICAGO, IL 60657-3133
Phone number: