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Individual
LILINE THEAGENE
Active
Individual
LILINE THEAGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TF0000X
Family Psychologist
—
—
103TS0200X
School Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
DC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
12/03/2024
Last updated
02/17/2025
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