Individual
LAUREN ANN VAN LAETHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CBIS, CRC
Contact information
Practice address
11406 HERITAGE GREEN DR, CORNELIUS, NC 28031-7402
(704) 733-0111
Mailing address
11406 HERITAGE GREEN DR, CORNELIUS, NC 28031-7402
(704) 733-0111
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
324570
NC
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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