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1164775458
SUSAN MARIE GAMBACH
CHAMPAIGN, IL
NPI
1164775458
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Professional Name
S. MARIE GAMBACH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149015516)
Enumeration Date
2012-10-24
Last Update Date
2012-10-24
Business Address
-- SUSAN MARIE GAMBACH LCSW
1514 COUNTRY LAKE DR
CHAMPAIGN, IL 61821-6428
Phone number: 217-637-1537
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Mailing Address
-- SUSAN MARIE GAMBACH LCSW
116 N CHESTNUT ST SUITE 243
CHAMPAIGN, IL 61820-4039
Phone number: 217-637-1537
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