Introspective Psychological Services, LLC
Psychologist, Clinical in Chicago, IL. Organization (NPI-2).
NPI number1164039822
StatusActive
Last updated in NPPESSep 28, 2020
Details
- NPI
- 1164039822
- Entity type
- Organization (NPI-2)
- Legal business name
- Introspective Psychological Services, LLC
- Organization subpart
- No
- Enumeration date
- Sep 28, 2020
- Certification date
- Sep 28, 2020
- Last updated
- Sep 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
Practice location
1502 W Chicago Ave # 1Chicago, IL 60642-5236
Phone 312-625-9051
Mailing address
2225 W Warren Blvd Apt 3Chicago, IL 60612-2472
Authorized official
Rielle Johnson
Owner
3126259051
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