Most Relevant Information
Provider Data
| NPI Number: | 1003663501 |
| Provider Name: | LASDAVAHN ASHLEY VONGPHAKDY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/02/2024 |
| Last Updated: | 05/02/2024 |
Provider Practice Location
1230 N HIGHLAND AVE
AURORA
IL
605061401
Practice Location Phone/Fax
| Phone: | 6309664331 |
| Fax: |
Provider Mailing Location
1230 N HIGHLAND AVE
AURORA
IL
605061401
Provider Mailing Phone/Fax
| Phone: | 6309664331 |
| Fax: |