WILLIAM TIVA BOUNTHONG

LOVES PARK, IL
NPI1144091505
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149025844)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: IL  149025844)
Enumeration Date2024-01-12
Last Update Date2024-02-22
Business Address
Mr. WILLIAM TIVA BOUNTHONG LCSW
7399 FOREST HILLS RD
LOVES PARK, IL 61111-3974
Phone number: 815-708-7392
Mailing Address
Mr. WILLIAM TIVA BOUNTHONG LCSW
7399 FOREST HILLS RD
LOVES PARK, IL 61111-3974
Phone number: 815-708-7392