LAURITA MARIE PROVANCAL

AURORA, IL
NPI1427710888
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149002677)
Enumeration Date2021-10-12
Last Update Date2021-10-12
Business Address
LAURITA MARIE PROVANCAL LCSW
1900 OGDEN AVE STE 106
AURORA, IL 60504-4284
Phone number: 630-256-8007
Mailing Address
LAURITA MARIE PROVANCAL LCSW
1900 OGDEN AVE STE 106
AURORA, IL 60504-4284
Phone number: 630-256-8007
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