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1770779969
LATISHA ANN O NEAL
DECATUR, IL
NPI
1770779969
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.017689)
Enumeration Date
2007-09-20
Last Update Date
2023-11-07
Business Address
LATISHA ANN O NEAL LCSW
102 W KENWOOD AVE STE 100
DECATUR, IL 62526-4379
Phone number: 217-872-3800
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Mailing Address
LATISHA ANN O NEAL LCSW
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone number: 217-545-8000
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