Individual
MRS. BETSY VAN BROCKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
340 W STATE ST, JACKSONVILLE, IL 62650-2061
(217) 245-6126
(217) 245-4296
Mailing address
710 N 8TH ST, SPRINGFIELD, IL 62702-6324
(217) 525-1064
(217) 525-1651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149016387
IL
Other
Enumeration date
04/13/2012
Last updated
01/02/2014
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