Individual
MRS. LAVINIA ARCHRANELL DOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
650 W 87TH ST, CHICAGO, IL 60620-2150
(773) 507-0261
Mailing address
650 W 87TH ST, CHICAGO, IL 60620-2150
(773) 507-0261
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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