Individual
LAURA OLTHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2612 W JOHN ST, CHAMPAIGN, IL 61821-3517
(217) 721-6312
Mailing address
2612 W JOHN ST, CHAMPAIGN, IL 61821-3517
(217) 721-6312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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