Organization
BALANCED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BRAMAN (LICENSED CLINICAL SOCIAL WORKER)
(309) 251-1900
Entity
Organization
Contact information
Practice address
607 W BURTON AVE, EUREKA, IL 61530-1356
(309) 251-1900
Mailing address
607 W BURTON AVE, EUREKA, IL 61530-1356
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149008793
IL
1041C0700X
Clinical Social Worker
Primary
149011988
IL
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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