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1215673082
JOHN WILLIAM LAFOLLETTE
LEBANON, IN
NPI
1215673082
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 86000408A)
Enumeration Date
2022-05-05
Last Update Date
2022-11-30
Business Address
JOHN WILLIAM LAFOLLETTE LAC, MATS
2374 SHAKER LN APT E
LEBANON, IN 46052-4100
Phone number: 317-797-0773
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Mailing Address
JOHN WILLIAM LAFOLLETTE LAC, MATS
4705 MEIJER CT
LAFAYETTE, IN 47905-4684
Phone number:
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