Individual provider · Type 1 NPI

Wanda Raquel Ortiz Hernandez, LCPC

Professional Counselor · Urbana, IL

NPI number 1104506393 Active

Practice location

2001 Philo Rd
Urbana, IL 61802-8007

Mailing address

309 W Clark St
Champaign, IL 61820-4637

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X180.015451 (IL)

Professional Counselor: Definition to come...

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About NPI 1104506393

Wanda Raquel Ortiz Hernandez, LCPC's National Provider Identifier is 1104506393, issued on Jul 21, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Urbana, IL. The record was last updated on Jul 21, 2023.