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Individual
MS. ELISABETH VAN DER KOLK
Active
Individual
MS. ELISABETH VAN DER KOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
102645
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
459408
TUFTS HEALTH PLAN
MA
01
—
VAP03254
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/29/2007
Last updated
07/24/2013
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