Individual
GWEN VANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
323 W MULBERRY ST, WATSEKA, IL 60970-1568
(815) 432-5241
(815) 432-4537
Mailing address
323 W MULBERRY ST, PO BOX 322, WATSEKA, IL 60970-1568
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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