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1336657170
LAURA M PROVANCAL
NAPERVILLE, IL
NPI
1336657170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149019272)
Enumeration Date
2018-01-15
Last Update Date
2018-01-15
Business Address
LAURA M PROVANCAL LCSW
2272 95TH ST STE 125
NAPERVILLE, IL 60564-8982
Phone number: 630-409-9700
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Mailing Address
LAURA M PROVANCAL LCSW
2272 95TH ST STE 125
NAPERVILLE, IL 60564-8982
Phone number: 630-409-9700
Copy
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