Individual
MISS LACIE NICOLE NEWLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 W WRIGHTWOOD AVE, APT. 220, CHICAGO, IL 60614-4959
(765) 366-5848
Mailing address
420 W WRIGHTWOOD AVE, APT. 220, CHICAGO, IL 60614-4959
(765) 366-5848
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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