Individual
MRS. LATREASA DENISE BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
500 E OGDEN AVE STE 101, NAPERVILLE, IL 60563-3264
(331) 444-2342
Mailing address
500 E OGDEN AVE STE 101, NAPERVILLE, IL 60563-3264
(331) 444-2342
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178017570
IL
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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