LATIA NICOLE SHANTAY RUSSELL

NORTH CHICAGO, IL
NPI1932413226
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.014170)
Enumeration Date2010-07-29
Last Update Date2010-07-29
Business Address
Mrs. LATIA NICOLE SHANTAY RUSSELL LCSW
3001 GREEN BAY RD
NORTH CHICAGO, IL 60064-3048
Phone number: 847-688-1900
Mailing Address
Mrs. LATIA NICOLE SHANTAY RUSSELL LCSW
3001 GREEN BAY RD
NORTH CHICAGO, IL 60064-3048
Phone number: 847-688-1900
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