Individual
MRS. CHANEL KOLTHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LCSW
Contact information
Practice address
1008 DECLARATION DR, SAVOY, IL 61874-7104
(580) 695-0526
Mailing address
1008 DECLARATION DR, SAVOY, IL 61874-7104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904014795
VA
1041C0700X
Clinical Social Worker
114763
TX
1041C0700X
Clinical Social Worker
149027046
IL
1041C0700X
Clinical Social Worker
Primary
61169653
WA
Other
Enumeration date
06/12/2019
Last updated
12/31/2024
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