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Individual
KENNETH WESEMANN
Active
Individual
KENNETH WESEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.013582
IL
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178.013582
STATE LICENSE
IL
Enumeration date
12/16/2018
Last updated
06/11/2019
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