Organization
PARENT FIRST EMPOWERMENT CONSULTATION TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE WIESMAN LCPC (OWNER)
(309) 242-2172
Entity
Organization
Contact information
Practice address
21W250 AUDUBON RD, LOMBARD, IL 60148-5205
(309) 242-2172
Mailing address
21W250 AUDUBON RD, LOMBARD, IL 60148-5205
(309) 242-2172
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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