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Organization
DW ENTERPRISES LLC
Active
Organization
DW ENTERPRISES LLC
Active
Other names
Hickory Creek Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORA MARIE WOLFE PSYD (LICENSED CLINICAL PSYCHOLOLIGST / D)
(815) 462-3827
Entity
Organization
Contact information
Practice address
331 ALANA DR, NEW LENOX, IL 60451-1766
(815) 462-3827
Mailing address
331 ALANA DR, NEW LENOX, IL 60451-1766
(815) 462-3827
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071006506
IL
103TC0700X
Clinical Psychologist
071006506
IL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
071006506
IL
Other
Enumeration date
03/12/2013
Last updated
08/28/2013
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