Individual
MRS. SUSAN J LUITEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7031 N PATTON LN, PEORIA, IL 61614-1918
(309) 369-9103
(309) 692-8775
Mailing address
7031 N PATTON LN, PEORIA, IL 61614-1918
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.003803
IL
Other
Enumeration date
02/24/2011
Last updated
02/24/2011
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