Individual
BRAD LEE WAHLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
14 PARK PL, SUITE B, SWANSEA, IL 62226-2929
(618) 624-5771
Mailing address
321 W PATTERSON ST, MASCOUTAH, IL 62258-1827
(872) 203-0837
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178012412
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
178012412
IL
101YM0800X
Mental Health Counselor
Primary
178012412
IL
101YP2500X
Professional Counselor
178012412
IL
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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