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1447706296
ANDREA TACK
ROCKFORD, IL
NPI
1447706296
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: IL 150.015410)
Enumeration Date
2016-08-31
Last Update Date
2017-06-30
Business Address
ANDREA TACK
3690 LAURA LN
ROCKFORD, IL 61114-8179
Phone number: 815-520-4145
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Mailing Address
ANDREA TACK
123456 MAIN STREET
ROCKFORD, IL 61114-8179
Phone number:
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