Individual
MELISSA A GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
119 W 1ST ST, SUITE 110, DIXON, IL 61021-3056
(815) 285-3073
Mailing address
119 W 1ST ST, SUITE 110, DIXON, IL 61021-3056
(815) 285-3073
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149010806
IL
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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