Individual
MRS. CLARISSA AMANDA LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 N 6TH ST, DEKALB, IL 60115-3407
(815) 501-6749
Mailing address
529 N 6TH ST, DEKALB, IL 60115-3407
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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