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Individual

NANCY ANN RUTKOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
712 N WASHINGTON ST, BLOOMINGTON, IN 47408-3450
(812) 330-1325
Mailing address
712 N WASHINGTON ST, BLOOMINGTON, IN 47408-3450
(812) 330-1325

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003667
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000185063
ANTHEM
IN
Enumeration date
02/09/2006
Last updated
07/08/2007
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