Doctor Name: | MS. SUSAN GAIL BEDNAR |
NPI Number: | 1093872897 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW, CDVC |
License Number: | |
Business Practice Address: | 6 Dunlap Ct Savoy, IL - 618749501 |
Business Phone Number: | 2173528502 |
Business Fax Number: | |
Mailing Address: | 1279 N 500 East Rd, MONTICELLO |
State: | IL |
Postal Code: | 618568245 |
Phone Number: | 2177623516 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
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 |