Individual
MS. MIMI ELIZABETH GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 VALLEY DR, VALPARAISO, IN 46383-2520
(219) 413-5100
Mailing address
7838 W FRANKFORT SQUARE RD, FRANKFORT, IL 60423-9139
(815) 464-1198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149005389
IL
1041C0700X
Clinical Social Worker
Primary
34003903A
IN
Other
Enumeration date
09/25/2013
Last updated
05/17/2021
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