Individual
MRS. AVA LAVON BLALARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
18W101 STANDISH LN, VILLA PARK, IL 60181-3644
(773) 469-5499
Mailing address
18W101 STANDISH LN, VILLA PARK, IL 60181-3644
(773) 469-5499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149.017574
IL
1041S0200X
School Social Worker
Primary
2246775
IL
Other
Enumeration date
01/29/2009
Last updated
07/25/2016
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