Most Relevant Information
Provider Data
| NPI Number: | 1003422437 |
| Provider Name: | LISETT TITO LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 149022444 |
Most Important Dates
| Enumeration Date: | 09/21/2020 |
| Last Updated: | 09/21/2020 |
Provider Practice Location
1520 N KOSTNER AVE
CHICAGO
IL
606511610
Practice Location Phone/Fax
| Phone: | 3122168040 |
| Fax: |
Provider Mailing Location
4342 W PARKER AVE
CHICAGO
IL
606392035
Provider Mailing Phone/Fax
| Phone: | 7733660476 |
| Fax: |