Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 149.018815 | IL |
NPI | 1003214289 |
---|---|
Provider Name | Ms. Regan Murphy |
First Address | Chicago, IL 60622-3766 |
Second Address | Chicago, IL 60640-7908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2014 |
Last Update Date | 18/02/2019 |