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Individual

MS. DIANE GRIMARD WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC, BCN

Contact information

Practice address
333 W WACKER DR STE 500, CHICAGO, IL 60606-1225
(312) 925-5176
Mailing address
333 W WACKER DR STE 500, CHICAGO, IL 60606-1225
(312) 925-5176

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180001245
IL

Other

Enumeration date
08/05/2009
Last updated
10/11/2011
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