Doctor Name: | MRS. SALLY B BRANCH |
NPI Number: | 1053491571 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149.005324 |
Business Practice Address: | 5225 Old Orchard Rd Suite29 Skokie, IL - 600774405 |
Business Phone Number: | 8472516019 |
Business Fax Number: | 8472514037 |
Mailing Address: | 345 Ivy Ct, KENILWORTH |
State: | IL |
Postal Code: | 600431172 |
Phone Number: | 8472516019 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 09/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149.005324 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |