Individual
SASIA LILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403
(262) 638-6744
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16017
WI
Other
Enumeration date
10/27/2015
Last updated
07/06/2018
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