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1720147424
NICOLE LIS
LIBERTYVILLE, IL
NPI
1720147424
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149012224)
Enumeration Date
2006-12-08
Last Update Date
2007-07-09
Business Address
-- NICOLE LIS LCSW
31480 N US HIGHWAY 45
LIBERTYVILLE, IL 60048-9444
Phone number: 847-680-2715
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Mailing Address
-- NICOLE LIS LCSW
31480 US HIGHWAY 45
LIBERTYVILLE, IL 60048
Phone number: 847-680-2715
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