Individual
MR. JESSE PATRICK WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAED, LMFT
Contact information
Practice address
8658 S SACRAMENTO AVE, CHICAGO, IL 60652-3800
(773) 962-3740
Mailing address
PO BOX 204, PLAINFIELD, IL 60544-0204
(270) 312-7752
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
104021
KY
106H00000X
Marriage & Family Therapist
Primary
166.001334
IL
Other
Enumeration date
05/14/2013
Last updated
08/27/2024
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