Organization
GOOD FRUIT TX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHARA SHAW (PROFESSIONAL COUNSELOR)
(815) 324-4367
Entity
Organization
Contact information
Practice address
1755 PARK STREET SUITE 200 #1071, NAPERVILLE, IL 60563
(815) 324-4367
Mailing address
PO BOX 2041, JOLIET, IL 60434-2041
(815) 324-4367
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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