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1245693506
LONI AMANDA WILSON
ROCKFORD, IL
NPI
1245693506
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.018037)
Enumeration Date
2016-04-03
Last Update Date
2016-04-03
Business Address
Ms. LONI AMANDA WILSON LCSW
321 W STATE ST SUITE 5
ROCKFORD, IL 61101-1137
Phone number: 815-969-8836
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Mailing Address
Ms. LONI AMANDA WILSON LCSW
321 W STATE ST SUITE 5
ROCKFORD, IL 61101-1137
Phone number: 815-969-8836
Copy
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