Individual
BRADY LUMSARGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSWCL
Contact information
Practice address
3310 N PROSPECT RD, PEORIA, IL 61603-1550
(309) 688-2170
Mailing address
3310 N PROSPECT RD, PEORIA, IL 61603-1550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L1091885
MI
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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