Most Relevant Information
Provider Data
| NPI Number: | 1003556416 |
| Provider Name: | LYNSEY LATTYAK |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 178016352 |
Most Important Dates
| Enumeration Date: | 04/01/2022 |
| Last Updated: | 07/12/2022 |
Provider Practice Location
13955 W GRENELEFE LN
HOMER GLEN
IL
604915923
Practice Location Phone/Fax
| Phone: | 7084084866 |
| Fax: |
Provider Mailing Location
13955 W GRENELEFE LN
HOMER GLEN
IL
604915923
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |