Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149.007877 | IL |
NPI | 1003070822 |
---|---|
Provider Name | Mrs. Cynthia Joann Robinson |
First Address | Ottawa, IL 61350-2833 |
Second Address | Ottawa, IL 61350-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |