Individual
NAOMI SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
12200 104TH ST, COAL VALLEY, IL 61240-9712
(309) 799-7044
Mailing address
127 E 3RD ST, COAL VALLEY, IL 61240-9305
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.104599
IL
Other
Enumeration date
12/11/2019
Last updated
09/10/2020
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