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Individual

KYMBERLY JAY WIEDENKELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, MFT

Contact information

Practice address
244 S RANDALL RD # 808, ELGIN, IL 60123-5529
(847) 595-0662
Mailing address
209 KELSEY RD, LAKE BARRINGTON, IL 60010-1557
(310) 429-1974

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
208001353
IL

Other

Enumeration date
04/29/2026
Last updated
04/29/2026
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