Most Relevant Information
Provider Data
| NPI Number: | 1003686676 |
| Provider Name: | TIMOTHY W LAWRENCE |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 180-001855 |
Most Important Dates
| Enumeration Date: | 01/04/2024 |
| Last Updated: | 01/04/2024 |
Provider Practice Location
803 W POPLAR ST
TAYLORVILLE
IL
625681815
Practice Location Phone/Fax
| Phone: | 2178272925 |
| Fax: |
Provider Mailing Location
803 W POPLAR ST
TAYLORVILLE
IL
625681815
Provider Mailing Phone/Fax
| Phone: | 2178272925 |
| Fax: |