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General NPI Number Information
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NPI Number | 1598128688
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Entity Type | Organization
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Legal Business Name | SANDRA E WOZNICKI, INC
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 227 N THROOP ST
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City | WOODSTOCK
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State | IL
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Zip | 60098-3224
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Country | US
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Telephone | 815-206-5811
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Fax | 815-206-5811
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Provider Business Mailing Address
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Address Line | 227 N THROOP ST
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City | WOODSTOCK
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State | IL
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Zip | 60098-3224
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Country | US
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Telephone | 815-206-5811
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Fax | 815-206-5811
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SANDRA E WOZNICKI
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Credential | LCPC
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Telephone | 815-206-5811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005942
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License Number State | IL
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