| NPI | 1396106647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE CREE Credentialing Coordinator 800-773-1682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.016759) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |