Individual
JILLIAN GONTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
804 N COLLEGE AVE, BLOOMINGTON, IN 47404-3526
(812) 219-4918
Mailing address
2909 S SARE RD, BLOOMINGTON, IN 47401-4331
(317) 354-9820
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007566A
IN
Other
Enumeration date
01/28/2018
Last updated
01/28/2018
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