Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003293226 |
---|---|
Provider Name | Whitney Hussong |
First Address | Aurora, IL 60506-1401 |
Second Address | Aurora, IL 60506-1401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2015 |
Last Update Date | 27/04/2015 |