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NPI 1063137164

NPI 1063137164 : MS. SAKEENA DEAN : CRESTWOOD, IL

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General NPI Number Information
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    NPI Number           |    1063137164
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    Entity Type          |    Individual 
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    Provider Name        |    MS. SAKEENA DEAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/11/2022
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    Last Update Date     |    10/11/2022
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Provider Practice Location Address
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    Address Line         |    13020 S CENTRAL AVE 
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    City                 |    CRESTWOOD
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    State                |    IL
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    Zip                  |    60418-2710
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    Country              |    US
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    Telephone            |    708-293-3605
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    877 MACKINAW AVE 
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    City                 |    CALUMET CITY
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    State                |    IL
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    Zip                  |    60409-4411
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    Country              |    US
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    Telephone            |    773-930-5258
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041S0200X
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    Taxonomy Name        |    School Social Worker
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    License Number       |    
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    License Number State |    
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