Provider Information for 1780921494
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Ms. KENITA J. PERRY-BELL L.C.S.W.
Sex: Female
NPI: 1780921494
Last Updated: 2014-02-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1780921494 | ||||||||
| Enumeration Date | 2013-01-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 5885 VILLA PARK, IL 60181-5310 United States Phone: 630-474-5279 | Fax:630-785-3064 | ||||||||
| Primary Practice Address | 2000 W ROOSEVELT RD BROADVIEW, IL 60155-3910 United States Phone: 630-474-5279 | Fax:630-785-3064 | ||||||||
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