ANDREA BLAYLOCK

CHICAGO, IL
NPI1801149513
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149-008354)
Enumeration Date2012-10-18
Last Update Date2012-10-18
Business Address
-- ANDREA BLAYLOCK LCSW
4611 N BEACON ST #1S
CHICAGO, IL 60640-4669
Phone number: 312-882-4817
Mailing Address
-- ANDREA BLAYLOCK LCSW
4611 N BEACON ST #1S
CHICAGO, IL 60640-4669
Phone number: 312-882-4817