Individual
LAURA DEFFLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 IRONWOOD CC DRIVE, NORMAL, IL 61761
(309) 322-7593
Mailing address
1900 E COLLEGE AVE # A128, NORMAL, IL 61761-4507
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.015701
IL
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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