JEPHTHAT MCDANIEL

LOMBARD, IL
NPI1861273781
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2023-10-06
Last Update Date2023-10-06
Business Address
JEPHTHAT MCDANIEL
2200 S GRACE ST APT 605
LOMBARD, IL 60148-5514
Phone number: 312-709-5351
Mailing Address
JEPHTHAT MCDANIEL
1001 ROHLWING RD
ELK GROVE VLG, IL 60007-3217
Phone number: 312-709-5351
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