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Individual

ANT WALACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6072 BRYNWOOD DR STE 205, ROCKFORD, IL 61114-5829
(815) 846-0684
Mailing address
11128 HAMBORG RD, ROSCOE, IL 61073-9111
(510) 590-6006

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
08/15/2025
Last updated
08/15/2025
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