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General NPI Number Information
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NPI Number | 1811266919
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Entity Type | Organization
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Legal Business Name | BRIAN KLAUNG MSW INC
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 6975 REDANSA DRIVE
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City | ROCKFORD
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State | IL
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Zip | 61108-1201
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Country | US
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Telephone | 815-398-7000
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Fax | 815-395-0671
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Provider Business Mailing Address
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Address Line | 6975 REDANSA DRIVE
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City | ROCKFORD
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State | IL
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Zip | 61108-1201
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Country | US
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Telephone | 815-398-7000
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MR. BRIAN DAVID KLAUNG
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Credential | MSW
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Telephone | 815-398-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 194-004675
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License Number State | IL
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