Individual
MRS. JAMIE LYNN KWIATKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, NBCC, LPC
Contact information
Practice address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 533-1391
Mailing address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 533-1391
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.007623
IL
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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