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1164046447
JACOB LORENZ
VIENNA, IL
NPI
1164046447
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-06-03
Last Update Date
2020-06-03
Business Address
JACOB LORENZ BA, MHP
101 OLIVER ST
VIENNA, IL 62995-1660
Phone number: 618-658-2611
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Mailing Address
JACOB LORENZ BA, MHP
101 OLIVER ST
VIENNA, IL 62995-1660
Phone number: 618-658-2611
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