Benjamin Waughtal, LPC

NPI #1528470507 in Fox River Grove, Illinois

Provider Information

NPI Number: 1528470507
Entity Type: Individual
Name: Benjamin Waughtal, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: May 27, 2014
Last Updated: May 27, 2014

Practice Location

Address: 930 IL ROUTE 22
City: Fox River Grove
State: Illinois
ZIP Code: 60021-1905
Phone: (847) 868-3435

Specialties & Taxonomy Codes

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

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