Lawrence Clinton Tice LCSW

NPI 1114183266 - Social Worker - 1041C0700X

NPI Details
NPI 1114183266
Gender Male
Enumeration Date 07/29/2008
Last Updated 07/29/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
5000 S EAST AVE APT 7C
APT 7C
CHICAGO IL, 60615-3177, US
Phone (773) 363-6757
Fax
Business Location
5000 S EAST END AVE APT 7C
CHICAGO IL, 60615-3177, US
Phone (773) 363-6757
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Illinois
License Number 149-001771
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According to our database, Mr. Lawrence Clinton Tice LCSW NPI is 1114183266, taxonomy code is 1041C0700X and license number is 149-001771, license state is located at Illinois. Lawrence Clinton Tice LCSW physically located at 5000 S East Ave Apt 7c, Chicago IL, 60615-3177. NPI Number Lawrence Clinton Tice LCSW has the Individual type.

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1114183266 NPI number is provided on an as is basis without warranty of any kind. 1114183266 is maintained by the National Plan & Provider Enumeration System. The contents of Lawrence Clinton Tice LCSW are for informational purposes only.