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Individual

LAURYN CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
1178 AMOS DR, MONTICELLO, IL 61856-8410

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/26/2013
Last updated
06/26/2013
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