LIDA WAGNER

NILES, IL
NPI1386947737
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149014271)
Enumeration Date2010-12-07
Last Update Date2010-12-07
Business Address
-- LIDA WAGNER LCSW
999 CIVIC CENTER DR
NILES, IL 60714-3224
Phone number: 847-588-8460
Mailing Address
-- LIDA WAGNER LCSW
999 CIVIC CENTER DR
NILES, IL 60714-3224
Phone number: 847-588-8460