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1124410675
LISA JANE WIESE
CHICAGO, IL
NPI
1124410675
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149014977)
Enumeration Date
2015-02-20
Last Update Date
2015-02-20
Business Address
-- LISA JANE WIESE LCSW
2950 W CHICAGO AVE SUITE 202
CHICAGO, IL 60622-4375
Phone number: 773-632-8675
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Mailing Address
-- LISA JANE WIESE LCSW
2020 N MOZART ST APT 221
CHICAGO, IL 60647-3977
Phone number: 773-632-8675
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