ETHAN KENT LACEY

WHEATON, IL
NPI1881302479
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2022-11-11
Last Update Date2022-11-11
Business Address
ETHAN KENT LACEY
1616 E ROOSEVELT RD STE 8
WHEATON, IL 60187-6850
Phone number: 630-588-1201
Mailing Address
ETHAN KENT LACEY
1616 E ROOSEVELT RD STE 8
WHEATON, IL 60187-6850
Phone number: 630-588-8043
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