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Organization
SHIRLEY CLAASSEN DICK LLC
Active
Organization
SHIRLEY CLAASSEN DICK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY CLAASSEN DICK (SOLE MEMBER)
(574) 238-5842
Entity
Organization
Contact information
Practice address
1930 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-2161
Mailing address
1930 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-2161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001401A
IN
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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