Washington Cisco LCSW

NPI 1457698912 - Social Worker - 1041C0700X

NPI Details
NPI 1457698912
Gender Male
Enumeration Date 01/03/2013
Last Updated 01/03/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
2870 E JEFFERSON ST
CENTRALIA IL, 62801-8530, US
Phone (618) 249-6863
Fax
Business Location
2870 E JEFFERSON ST
CENTRALIA IL, 62801-8530, US
Phone (618) 249-6863
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Illinois
License Number 149.005632
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According to our database, Washington Cisco LCSW NPI is 1457698912, taxonomy code is 1041C0700X and license number is 149.005632, license state is located at Illinois. Washington Cisco LCSW physically located at 2870 E Jefferson St, Centralia IL, 62801-8530. NPI Number Washington Cisco LCSW has the Individual type.

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1457698912 NPI number is provided on an as is basis without warranty of any kind. 1457698912 is maintained by the National Plan & Provider Enumeration System. The contents of Washington Cisco LCSW are for informational purposes only.