Individual
JOSETTE WOLTHUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3413 N KENNICOTT AVE STE A, ARLINGTON HEIGHTS, IL 60004-7815
(847) 240-2211
Mailing address
3414A N KENNICOTT AVENUE, ARLINGTON, IL 60004-5905
(847) 240-2211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005997
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633897
BCBS GRP NUMBER
IL
01
—
320078
VALUE OPTIONS GRP NUMBER
IL
Enumeration date
11/08/2006
Last updated
07/12/2011
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