Jessica Marie Dergance, LCSW
Social Worker, Clinical in La Salle, IL. Individual provider (NPI-1).
NPI number1811293095
StatusActive
Last updated in NPPESJul 24, 2018
Details
- NPI
- 1811293095
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jessica Marie Dergance
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 4, 2011
- Last updated
- Jul 24, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149014277 | IL | Yes |
Practice location
2428 Chartres StLa Salle, IL 61301-1107
Phone 815-780-8765 · Fax 815-780-8766
Mailing address
2428 Chartres StLa Salle, IL 61301-1107
Phone 815-224-1610 · Fax 815-223-1634
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