Individual
SONYA LORELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3535 W BELMONT AVE REAR 2, CHICAGO, IL 60618-5458
(757) 613-2168
Mailing address
3535 W BELMONT AVE REAR 2, CHICAGO, IL 60618-5458
(757) 613-2168
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701004351
VA
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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