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General NPI Number Information
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NPI Number | 1093187593
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Entity Type | Individual
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Provider Name | LAURALYNN ALTON MHP
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Gender | Female
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 474 SUMMIT ST
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City | ELGIN
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State | IL
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Zip | 60120-3829
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Country | US
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Telephone | 224-535-9555
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Fax | 224-241-3183
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Provider Business Mailing Address
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Address Line | 474 SUMMIT ST
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City | ELGIN
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State | IL
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Zip | 60120-3829
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Country | US
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Telephone | 224-535-9555
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Fax | 224-241-3183
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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