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1386947737
LIDA WAGNER
NILES, IL
NPI
1386947737
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149014271)
Enumeration Date
2010-12-07
Last Update Date
2010-12-07
Business Address
-- LIDA WAGNER LCSW
999 CIVIC CENTER DR
NILES, IL 60714-3224
Phone number: 847-588-8460
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Mailing Address
-- LIDA WAGNER LCSW
999 CIVIC CENTER DR
NILES, IL 60714-3224
Phone number: 847-588-8460
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