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1346614435
RENITA SHORES-GASTON
ROCKFORD, IL
NPI
1346614435
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.017848)
Enumeration Date
2015-11-30
Last Update Date
2022-09-26
Business Address
RENITA SHORES-GASTON LCSW
5844 ELAINE DR STE 101
ROCKFORD, IL 61108-2494
Phone number: 815-373-3027
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Mailing Address
RENITA SHORES-GASTON LCSW
5844 ELAINE DR STE 101
ROCKFORD, IL 61108-2494
Phone number: 815-373-3027
Copy
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