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1225800493
SARA E PROVIS
PARK RIDGE, IL
NPI
1225800493
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: IL 178.019455)
Enumeration Date
2023-10-23
Last Update Date
2023-10-23
Business Address
MRS. SARA E PROVIS LPC
1422 LAVERNE AVE
PARK RIDGE, IL 60068-2561
Phone number: 847-529-8607
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Mailing Address
MRS. SARA E PROVIS LPC
1422 LAVERNE AVE
PARK RIDGE, IL 60068-2561
Phone number: 847-529-8607
Copy
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