Individual
MILDRED BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01713
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05025885815
PACIFICARE
—
01
—
1021740
GROUP NUMBER NHP
—
01
—
12400210
MULTIPLAN
—
01
—
26595-7
BLUE CROSS BLUE SHIELD
—
01
—
410724
BLUE CHIP
—
05
—
MB321125
—
RI
Enumeration date
01/09/2007
Last updated
07/08/2007
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