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1396259081
WANDA DIDERICH
ROCKFORD, IL
NPI
1396259081
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178013374)
Enumeration Date
2017-11-17
Last Update Date
2017-11-17
Business Address
WANDA DIDERICH
8616 NORTHERN AVE
ROCKFORD, IL 61107-5309
Phone number: 815-332-8003
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Mailing Address
WANDA DIDERICH
1021 N MULFORD RD
ROCKFORD, IL 61107-3877
Phone number: 815-387-5600
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