Individual
JENNIFER LYNN ILLIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
138 GERLOFF RD, SCHWENKSVILLE, PA 19473-1719
(484) 302-8536
Mailing address
3122 KING LANE, PHOENIXVILLE, PA 19460
(484) 843-3866
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW012871L
PA
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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