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1104506393
WANDA RAQUEL ORTIZ HERNANDEZ
URBANA, IL
NPI
1104506393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180.015451)
Enumeration Date
2023-07-21
Last Update Date
2023-07-21
Business Address
WANDA RAQUEL ORTIZ HERNANDEZ LCPC
2001 PHILO RD
URBANA, IL 61802-8007
Phone number: 217-552-1211
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Mailing Address
WANDA RAQUEL ORTIZ HERNANDEZ LCPC
309 W CLARK ST
CHAMPAIGN, IL 61820-4637
Phone number: 217-398-9066
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