Individual
MS. LAKEN J SISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E STATE ST, ROCKFORD, IL 61104-1012
(815) 668-7810
(815) 714-6219
Mailing address
301 E STATE ST, ROCKFORD, IL 61104-1012
(815) 990-5265
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/12/2018
Last updated
05/01/2019
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