Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149006633 | IL |
NPI | 1003108903 |
---|---|
Provider Name | Ms. Aviva Cahn |
First Address | Chicago, IL 60657-3952 |
Second Address | Chicago, IL 60601-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 10/05/2011 |