Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149016281 | IL |
NPI | 1003211582 |
---|---|
Provider Name | Mrs. Natalie Galarza |
First Address | Chicago, IL 60630-3330 |
Second Address | Chicago, IL 60640-4689 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2014 |
Last Update Date | 27/10/2014 |