| Ride The Wave Wellness, Inc. | |
|
123 W Washington St Ste 340 Oswego IL 60543-8292 | |
| (630) 383-7006 | |
| (630) 383-7006 |
| Full Name | Ride The Wave Wellness, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 123 W Washington St Ste 340, Oswego, Illinois |
| Authorized Official Name and Position | Nicole K Knepper (OWNER/CLINICAL PSYCHOTHERAPIST) |
| Authorized Official Contact | 6303837006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ride The Wave Wellness, Inc. 2405 Twin Fountain Ct Plainfield IL 60586-6397 Ph: (773) 655-1198 | Ride The Wave Wellness, Inc. 123 W Washington St Ste 340 Oswego IL 60543-8292 Ph: (630) 383-7006 |
| NPI Number | 1356863617 |
|---|---|
| Provider Enumeration Date | 07/08/2017 |
| Last Update Date | 07/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356863617 | NPI | - | NPPES |
| 1194092635 | Other | IL | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180.0004778 (Illinois) | Primary |
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