Individual
MR. DALE HORAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
412 ELLES AVE, CARTERVILLE, IL 62918-1517
(618) 985-8282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.014662
IL
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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