MRS. Lisa Louise Wild, M.S.E.D, M.S.W.

NPI #1184733693 in Pinckneyville, Illinois

Provider Information

NPI Number: 1184733693
Entity Type: Individual
Name: MRS. Lisa Louise Wild, M.S.E.D, M.S.W.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: M.S.E.D, M.S.W.
Enumeration Date: Aug 29, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 313 S WALNUT ST
City: Pinckneyville
State: Illinois
ZIP Code: 62274-1342
Phone: (618) 357-1407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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