Individual
MRS. LAURA JEAN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1267 BRENDAN DR, MORRIS, IL 60450-2425
(815) 953-5472
Mailing address
1267 BRENDAN DR, MORRIS, IL 60450-2425
(815) 953-5472
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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