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Individual

MRS. PENNI L IPPENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1521 BROADWAY ST, QUINCY, IL 62301-2815
(217) 228-6193
Mailing address
1521 BROADWAY ST, QUINCY, IL 62301-2815
(217) 228-6193

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149005812
IL

Other

Enumeration date
01/17/2007
Last updated
08/05/2024
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