Individual
MRS. LAVONNE LEE LOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5407 8TH AVE, KENOSHA, WI 53140-3715
(262) 564-0067
(262) 652-1411
Mailing address
W155S7648 RAIN TREE CT, MUSKEGO, WI 53150-7762
(262) 678-0487
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3822-125
WI
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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