Individual
PETRITA LAVERNE SALAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
526 S BUREAU VALLEY PKWY STE B, PRINCETON, IL 61356-2066
(815) 875-4548
(815) 875-8602
Mailing address
PO BOX 535, PRINCETON, IL 61356-0535
(815) 875-4548
(815) 875-8602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180006442
IL
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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