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Individual
MISS KIMBERLEY B HERZOG
Active
Individual
MISS KIMBERLEY B HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
I1501458S
OH
104100000X
Social Worker
149021356
IL
1041C0700X
Clinical Social Worker
Primary
149021356
IL
Other
Enumeration date
01/04/2016
Last updated
08/12/2019
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