Individual
MRS. EILEEN M MCILTROT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
10271 DEER RUN FARMS RD, SUITE 3, FORT MYERS, FL 33966-1078
(239) 851-1838
Mailing address
3960 ELLIS RD, FORT MYERS, FL 33905-6400
(239) 851-1838
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z9956
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
05/17/2008
Last updated
05/17/2008
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