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1770340085
LA SHAWN RAYNARD STALLWORTH
AURORA, IL
NPI
1770340085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2024-03-04
Last Update Date
2024-03-04
Business Address
LA SHAWN RAYNARD STALLWORTH
1630 PLUM ST
AURORA, IL 60506-3462
Phone number: 630-966-4475
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Mailing Address
LA SHAWN RAYNARD STALLWORTH
1630 PLUM ST
AURORA, IL 60506-3462
Phone number: 630-966-4475
Copy
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