Individual
LAURIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1113 W GREENWOOD AVE, WAUKEGAN, IL 60087-4908
(847) 244-4434
Mailing address
1113 W GREENWOOD AVE, WAUKEGAN, IL 60087-4908
(847) 244-4434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23587
IL
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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