Individual
CLETUS A MEIERGERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
501 ELLA AVE, JOLIET, IL 60433-2799
(815) 727-8521
Mailing address
25029 S FOXFORD DR, MANHATTAN, IL 60442-9160
(815) 478-3282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149006629
IL
Other
Enumeration date
03/15/2007
Last updated
08/05/2010
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