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Individual

MRS. AMY JEAN WILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA LCPC

Contact information

Practice address
201 PARK PL, SUITE 24, BOURBONNAIS, IL 60914-1885
(815) 935-0333
(815) 928-9200
Mailing address
201 PARK PL, SUITE 24, BOURBONNAIS, IL 60914-1885
(815) 935-0333
(815) 928-9200

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.007352
IL

Other

Enumeration date
11/23/2009
Last updated
11/23/2009
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