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Individual

AMY C MAKICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
315 W DODDS ST, BLOOMINGTON, IN 47403-2510
(812) 669-2227
(812) 669-2227
Mailing address
1225 S PALMER AVE, BLOOMINGTON, IN 47401-5955
(812) 325-7513

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004062A
IN

Other

Enumeration date
12/12/2017
Last updated
12/12/2017
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