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Jessica Kathleen Gent Ryder, L.C.S.W.

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

NPI number1154787992
StatusActive
Last updated in NPPESMar 20, 2016

Details

NPI
1154787992
Entity type
Individual (NPI-1)
Name
Mrs. Jessica Kathleen Gent Ryder
Credential
L.C.S.W.
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 9, 2016
Last updated
Mar 20, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical149.014207ILYes

Practice location

200 W Monroe St
Suite #305
Bloomington, IL 61701-3997

Phone 309-838-9310

Mailing address

1904 E Taylor St
Bloomington, IL 61701-5714

Phone 309-838-9310

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