Individual
CARLY WOLFRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
1 E NORTHWEST HWY, PALATINE, IL 60067-1708
(815) 236-5503
Mailing address
1403 TALL OAKS DR, CAROL STREAM, IL 60188-4204
(815) 236-5503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180014654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114492303
INDIVIDUAL NPI
IL
Enumeration date
10/04/2018
Last updated
09/30/2022
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