JACQUELINE MARIE KLIETZ

ROCKFORD, IL
NPI1538672043
Former NameJACQUELINE MARIE GRAY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: IL  166.001072)
Enumeration Date2017-11-07
Last Update Date2018-10-02
Business Address
Mrs. JACQUELINE MARIE KLIETZ LMFT
5666 E STATE ST
ROCKFORD, IL 61108-2425
Phone number: 815-484-7053
Mailing Address
Mrs. JACQUELINE MARIE KLIETZ LMFT
2430 BARRINGTON PL
ROCKFORD, IL 61107-1830
Phone number: