Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | IL |
NPI | 1003031196 |
---|---|
Provider Name | Bridget Wesley |
First Address | Arlington Heights, IL 60004-7803 |
Second Address | Arlington Heights, IL 60004-7803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |