Individual
AMANDA LAFAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3317 W 95TH ST, SUITE 101, EVERGREEN PARK, IL 60805-2243
(708) 955-2650
Mailing address
3317 W 95TH ST, SUITE 101, EVERGREEN PARK, IL 60805-2243
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.009208
IL
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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