Individual
MS. DEBORAH ANN BURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
421 W EXCHANGE ST, FREEPORT, IL 61032-4008
(815) 599-7300
(815) 599-7948
Mailing address
PO BOX 813, 421 W EXCHANGE, FREEPORT, IL 61032
(815) 599-7300
(815) 599-7948
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149005650
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149005650
STATE LICENSED
IL
Enumeration date
05/04/2006
Last updated
07/21/2022
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