Individual
LANISE R WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1539 S KEDVALE AVE, CHICAGO, IL 60623-1941
(773) 403-0339
Mailing address
1539 S. KEDVALE AVE, CHICAGO, IL 60623-1941
(773) 403-0339
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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