Individual
JACOB KENNETH LAGRECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2670 FAIRFAX LN, LAKE IN THE HILLS, IL 60156-6319
(224) 762-1934
Mailing address
2670 FAIRFAX LN, LAKE IN THE HILLS, IL 60156-6319
(224) 762-1934
(111) 111-1111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L26243101090
IL
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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