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Individual
MISS SHALLAHDA V GAMBLE
Active
Individual
MISS SHALLAHDA V GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150116805
IL
164W00000X
Licensed Practical Nurse
043128148
IL
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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