Individual
EDNA NG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,SAP,CRADC,PCGC
Contact information
Practice address
4809 N SHERIDAN RD, PEORIA, IL 61614-5927
(309) 922-3177
Mailing address
10806 N OVERTONE ST, PEORIA, IL 61615-7480
(309) 922-3177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013867
IL
Other
Enumeration date
09/11/2012
Last updated
07/19/2014
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