Individual
LIZABETH A RATHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2050 N MAIN ST STE C, CROWN POINT, IN 46307-2048
(219) 662-3300
(219) 662-3300
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33005130A
IN
1041C0700X
Clinical Social Worker
Primary
34006070A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200275200A
—
IN
Enumeration date
10/09/2007
Last updated
09/05/2023
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