WASHINGTON CISCO

CENTRALIA, IL
NPI1457698912
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.005632)
Enumeration Date2013-01-03
Last Update Date2013-01-03
Business Address
-- WASHINGTON CISCO LCSW
2870 E JEFFERSON ST
CENTRALIA, IL 62801-8530
Phone number: 618-249-6863
Mailing Address
-- WASHINGTON CISCO LCSW
2870 E JEFFERSON ST
CENTRALIA, IL 62801-8530
Phone number: 618-249-6863
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