IndividualActive
Amanda Wagner
NPI 1205478294 · Marriage & Family Therapist · Orland Park, IL
Provider details
- NPI number
- 1205478294
- Entity type
- Individual
- Primary specialty
- Marriage & Family TherapistBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 208000757 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
7021 W 153rd St Ste 5
Orland Park, IL 60462-5397
Phone: (708) 275-0934
Fax: (888) 419-1594
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 764
Manteno, IL 60950-0764
Registry dates
- Enumerated
- 2019-10-11
- Last updated
- 2019-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.