Individual
MS. EILEEN MARTHA LIEZERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
210 N LONGWOOD ST, ROCKFORD, IL 61107-4134
(815) 962-5585
(815) 962-8945
Mailing address
210 N LONGWOOD ST, ROCKFORD, IL 61107-4134
(815) 962-5585
(815) 962-8945
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.001045
IL
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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