SUPATCHARA LAKSANAPROM

CHICAGO, IL
NPI1477198000
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: IL  071010079)
Enumeration Date2019-11-06
Last Update Date2019-11-06
Business Address
Dr. SUPATCHARA LAKSANAPROM PsyD
6323 N AVONDALE AVE STE 108
CHICAGO, IL 60631-1958
Phone number: 312-975-3307
Mailing Address
Dr. SUPATCHARA LAKSANAPROM PsyD
6323 N AVONDALE AVE STE 108
CHICAGO, IL 60631-1958
Phone number: 312-975-3307
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