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1144815994
MARY KATHLEEN WAGNER
CHICAGO, IL
NPI
1144815994
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149020151)
Enumeration Date
2021-03-03
Last Update Date
2021-03-03
Business Address
MARY KATHLEEN WAGNER LCSW CADC
2451 W CORTLAND ST APT 3
CHICAGO, IL 60647-0452
Phone number: 847-334-2755
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Mailing Address
MARY KATHLEEN WAGNER LCSW CADC
2451 W CORTLAND ST APT 3
CHICAGO, IL 60647-0452
Phone number: 847-334-2755
Copy
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