Individual
DR. DAVID RAY WENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D MIN LCPC
Contact information
Practice address
3040 N UNIVERSITY AVE, STE 2, DECATUR, IL 62526-1351
(217) 872-1700
(217) 872-1366
Mailing address
3040 N UNIVERSITY AVE, STE 2, DECATUR, IL 62526-1351
(217) 872-1700
(217) 872-1366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035840188
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/30/2006
Last updated
07/08/2007
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