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1114183266
LAWRENCE CLINTON TICE
CHICAGO, IL
NPI
1114183266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149-001771)
Enumeration Date
2008-07-29
Last Update Date
2008-07-29
Business Address
Mr. LAWRENCE CLINTON TICE LCSW
5000 S EAST AVE APT 7C APT 7C
CHICAGO, IL 60615-3177
Phone number: 773-363-6757
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Mailing Address
Mr. LAWRENCE CLINTON TICE LCSW
5000 S EAST END AVE APT 7C
CHICAGO, IL 60615-3177
Phone number: 773-363-6757
Copy
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