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Individual
MARISSA PATRICE KATES
Active
Individual
MARISSA PATRICE KATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150013469
IL
1041C0700X
Clinical Social Worker
Primary
149.016352
IL
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
01/23/2012
Last updated
12/12/2013
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