Individual
ILA A KEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
311 S NEW YORK RD, SUITE 25, GALLOWAY, NJ 08205-6025
(609) 748-1820
(609) 404-3116
Mailing address
311 S NEW YORK RD, SUITE 25, GALLOWAY, NJ 08205-6025
(609) 748-1820
(609) 404-3116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04607300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019887
—
NJ
Enumeration date
07/04/2006
Last updated
10/03/2014
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