Individual
CALEY WIETIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
906 DAVIS ST, EVANSTON, IL 60201-3608
(847) 492-1778
Mailing address
5621 N WAYNE AVE APT D1, CHICAGO, IL 60660-4257
(281) 844-0336
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/26/2017
Last updated
05/26/2017
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