Individual
MILI LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 E 11TH AVE, NAPERVILLE, IL 60563-2704
(630) 420-6332
Mailing address
735 MARKET DR, OSWEGO, IL 60543-4043
(630) 636-6909
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
158
IL
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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