Individual
MARJORIE ANN LA RICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 990, BELLEVILLE, IL 62223-5000
(618) 236-6501
(618) 236-6551
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 990, BELLEVILLE, IL 62223-5000
(618) 236-6501
(618) 236-6551
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
002508
MO
101Y00000X
Counselor
Primary
180001547
IL
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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