Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149.014262 | IL |
NPI | 1003223249 |
---|---|
Provider Name | Johanna Westin |
First Address | Paris, IL 61944-5118 |
Second Address | Paris, IL 61944-2210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 02/02/2015 |