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General NPI Number Information
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NPI Number | 1215976717
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Entity Type | Organization
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Legal Business Name | AMERICAN SPIRITUAL AND ECONOMIC EMPOWERMENT CORPORATION
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 9338 S MARQUETTE AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4130
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Country | US
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Telephone | 773-336-5869
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Fax |
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Provider Business Mailing Address
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Address Line | 9338 S MARQUETTE AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4130
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Country | US
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Telephone | 773-336-5869
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. TYRONE FRAZIER
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Credential | LCSW
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Telephone | 773-336-5869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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