Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149-008635 | IL |
NPI | 1003137738 |
---|---|
Provider Name | Hope Shamberg |
First Address | Deerfield, IL 60015-3142 |
Second Address | Highland Park, IL 60035-2622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 16/06/2010 |