Individual
LEA M VENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-6217
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-6217
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071009498
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
06/30/2015
Last updated
07/21/2022
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