Individual
BENJAMIN WAUGHTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
930 IL ROUTE 22, FOX RIVER GROVE, IL 60021-1905
(847) 868-3435
Mailing address
175 E HAWTHORN PKWY, VERNON HILLS, IL 60061-1463
(847) 868-3435
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178009075
IL
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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