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1063706497
CHARLES RUSSELL KERWIN
DECATUR, IL
NPI
1063706497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.014464)
Enumeration Date
2011-06-02
Last Update Date
2011-06-02
Business Address
Mr. CHARLES RUSSELL KERWIN LCSW, CADC
1770 ELAKE SHORE DR
DECATUR, IL 62521-3832
Phone number: 217-428-1900
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Mailing Address
Mr. CHARLES RUSSELL KERWIN LCSW, CADC
1770 EAST LAKE SHORE DR
DECATUR, IL 62521
Phone number: 217-428-1900
Copy
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