Lawrence Carlson Willoughby LCSW

NPI 1063488963 - Social Worker - 1041C0700X

NPI Details
NPI 1063488963
Gender Male
Enumeration Date 02/28/2006
Last Updated 09/28/2010
Entity Type Individual
Active Over 12 years ago
Practice Location
SOUTH BEND IN, 46617-2322, US
Phone (574) 533-1234
Fax (574) 537-2652
Business Location
PO BOX 809
GOSHEN IN, 46527-0809, US
Phone (574) 533-1234
Fax (574) 537-2652
Taxonomy Code 1041C0700X
License State Indiana
License Number 34002033A
Remove 1063488963 NPI Number

According to our database, Lawrence Carlson Willoughby LCSW NPI is 1063488963, taxonomy code is 1041C0700X and license number is 34002033A, license state is located at Indiana. Lawrence Carlson Willoughby LCSW physically located at 403 E Madison St, South Bend IN, 46617-2322. NPI Number Lawrence Carlson Willoughby LCSW has the Individual type.

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1063488963 NPI number is provided on an as is basis without warranty of any kind. 1063488963 is maintained by the National Plan & Provider Enumeration System. The contents of Lawrence Carlson Willoughby LCSW are for informational purposes only.