STEPHANIE LYNN PROVIS

FOX LAKE, IL
NPI1114711165
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2025-04-07
Last Update Date2025-04-07
Business Address
STEPHANIE LYNN PROVIS
34 W GRAND AVE STE 101
FOX LAKE, IL 60020-1224
Phone number: 847-322-2975
Mailing Address
STEPHANIE LYNN PROVIS
1307 W LINCOLN HWY APT 3107
DEKALB, IL 60115-2932
Phone number: 815-901-7781
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