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1861511719
LISA COBURN
JOLIET, IL
NPI
1861511719
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149009732)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
-- LISA COBURN LCSW
501 ELLA AVE
JOLIET, IL 60433-2799
Phone number: 815-727-8521
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Mailing Address
-- LISA COBURN LCSW
421 CORNELIA ST
JOLIET, IL 60435-6037
Phone number: 815-723-1092
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