Individual
MRS. DENISE A WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
19250 EVERETT LN, SUITE #102, MOKENA, IL 60448-8942
(708) 925-7258
Mailing address
680 LENOX ST, NEW LENOX, IL 60451-4200
(708) 925-7258
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180009160
IL
Other
Enumeration date
06/08/2014
Last updated
06/08/2014
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