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General NPI Number Information
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NPI Number | 1477091189
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Entity Type | Organization
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Legal Business Name | MARIANNE TOMLINSON THERAPY, LLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1605 W WILSON ST STE 111
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City | BATAVIA
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State | IL
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Zip | 60510-1682
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Country | US
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Telephone | 630-337-6571
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 W WILSON ST STE 111
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City | BATAVIA
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State | IL
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Zip | 60510-1682
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Country | US
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Telephone | 630-337-6571
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. MARIANNE TOMLINSON
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Credential | L.P.C.P
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Telephone | 630-337-6571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.019016
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License Number State | IL
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