Mayra Velasco

NPI #1720322662 in East Saint Louis, Illinois

Provider Information

NPI Number: 1720322662
Entity Type: Individual
Name: Mayra Velasco
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Nov 15, 2012
Last Updated: Nov 15, 2012

Practice Location

Address: 5601 STATE ST
City: East Saint Louis
State: Illinois
ZIP Code: 62203-1346
Phone: (618) 213-3170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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