Irma R. Ilustre, MSW, LICSW
NPI #1649329921 in Tewksbury, Massachusetts
Provider Information
- NPI Number
- 1649329921
- Entity Type
- Individual
- Name
- Irma R. Ilustre, MSW, LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- MSW, LICSW
- Enumeration Date
- Jan 9, 2007
- Last Updated
- Mar 18, 2008
Practice Location
- Address
- 170 MAIN ST
- Address 2
- UNIT G-02
- City
- Tewksbury
- State
- Massachusetts
- ZIP Code
- 01876-1765
- Phone
- (617) 969-7600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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