Organization
JAMIE LAURSON LCPC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LAURSON (COUNSELOR)
(309) 242-3975
Entity
Organization
Contact information
Practice address
2416 E WASHINGTON ST STE A3, BLOOMINGTON, IL 61704-1608
(309) 242-3975
Mailing address
2416 E WASHINGTON ST STE A3, BLOOMINGTON, IL 61704-1608
(309) 242-3975
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
11/03/2021
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