THIDAPORN IAMSUTTA

CHICAGO, IL
NPI1972001709
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2018-01-26
Last Update Date2018-01-26
Business Address
THIDAPORN IAMSUTTA QMHP
4753 N BROADWAY ST STE 700
CHICAGO, IL 60640-4995
Phone number: 773-293-8430
Mailing Address
THIDAPORN IAMSUTTA QMHP
4753 N BROADWAY ST STE 700
CHICAGO, IL 60640-4995
Phone number: 773-293-8430
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