MR. Michael John Trader, L.C.S.W.

NPI #1053474460 in Rockford, Illinois

Provider Information

NPI Number: 1053474460
Entity Type: Individual
Name: MR. Michael John Trader, L.C.S.W.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: L.C.S.W.
Enumeration Date: Dec 18, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 129 PHELPS AVE
Address 2: SUITE 818
City: Rockford
State: Illinois
ZIP Code: 61108-2453
Phone: (815) 229-6316

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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