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Individual
TIA NIX
Active
Individual
TIA NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149023007
IL
1041C0700X
Clinical Social Worker
34012467A
IN
Other
Enumeration date
03/27/2021
Last updated
04/07/2026
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