Individual
BROOKE FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
545 WILLOW ST, VINCENNES, IN 47591-1064
(812) 882-0509
Mailing address
545 WILLOW ST, VINCENNES, IN 47591-1064
(812) 882-0509
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99093748A
IN
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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