Individual
TARYN JOELLE HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1345 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1844
(563) 421-4406
Mailing address
1112 20TH AVE, EAST MOLINE, IL 61244-2222
(309) 558-9760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
06721
IA
1041C0700X
Clinical Social Worker
149011719
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06721
LISW
IA
Enumeration date
02/09/2007
Last updated
08/02/2021
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