Individual
CHETNA VITHAL GORDHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(888) 924-3786
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(618) 512-1502
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.024228
IL
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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