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Organization

INNER WILD THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JODI RANDLE LCPC (OWNER/CEO)
(773) 818-5875
Entity
Organization

Contact information

Practice address
840 W IRVING PARK RD # 302, CHICAGO, IL 60613-3011
(872) 269-4203
Mailing address
3453 W 115TH PL, CHICAGO, IL 60655-3622
(773) 818-5875

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
04/16/2024
Last updated
04/16/2024
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