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Mary Therese Boyle, LCSW

Social Worker, Clinical in Wilmington, IL. Individual provider (NPI-1).

NPI number1104376375
StatusActive
Last updated in NPPESOct 11, 2016

Details

NPI
1104376375
Entity type
Individual (NPI-1)
Name
Mary Therese Boyle
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 11, 2016
Last updated
Oct 11, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical149.018807ILYes

Practice location

523 Barnes Dr
Wilmington, IL 60481-1500

Phone 773-330-7102

Mailing address

523 Barnes Dr
Wilmington, IL 60481-1500

Phone 773-330-7102

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