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Individual
ILENE L. DILLON
Active
Individual
ILENE L. DILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 7035
CA
106H00000X
Marriage & Family Therapist
MFC 5747
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS 7035
CLINICAL SOCIAL WK LIC
CA
01
—
MFC 5747
MFT LICENSE NUMBER
CA
01
—
ZZZ70577Z
BLUE SHIELD
CA
Enumeration date
01/29/2007
Last updated
01/26/2015
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