Organization
BLISS PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARI WITTUM LCPC, MSCP (PSYCHOTHERAPIST)
(630) 377-7171
Entity
Organization
Contact information
Practice address
16 N RIVERSIDE AVE, SAINT CHARLES, IL 60174-1967
(630) 377-7171
(630) 584-8233
Mailing address
16 N RIVERSIDE AVE, SAINT CHARLES, IL 60174-1967
(630) 377-7171
(630) 584-8233
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180005941
IL
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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