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1023142494
LAURA A LICEA
CHICAGO, IL
NPI
1023142494
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149-010496)
Enumeration Date
2007-03-15
Last Update Date
2007-07-09
Business Address
-- LAURA A LICEA LCSW
5359 W FULLERTON AVE
CHICAGO, IL 60639-1450
Phone number: 708-836-2785
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Mailing Address
-- LAURA A LICEA LCSW
5359 W FULLERTON AVE
CHICAGO, IL 60639-1450
Phone number: 708-836-2785
Copy
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