Provider Information for 1316598550
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ERIN DALE WOLD LPC, NCC, PEL
Sex: Female
NPI: 1316598550
Last Updated: 2019-09-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316598550 | ||||||||||||||
| Enumeration Date | 2019-09-27 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 2400 GLENWOOD AVE STE 126 JOLIET, IL 60435-5495 United States Phone: 815-730-7521 | Fax:815-730-7524 | ||||||||||||||
| Primary Practice Address | 2400 GLENWOOD AVE STE 126 JOLIET, IL 60435-5495 United States Phone: 815-730-7521 | Fax:815-730-7524 | ||||||||||||||
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