Organization
AYA LIFE THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATREASA DENISE BLACKMON LCPC (OWNER/CLINICAL THERAPIST)
(269) 767-2980
Entity
Organization
Contact information
Practice address
1280 IROQUOIS AVE STE 102A, NAPERVILLE, IL 60563-8559
(331) 230-0338
Mailing address
1280 IROQUOIS AVE STE 102A, NAPERVILLE, IL 60563-8559
(331) 230-0338
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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