Jenna Gidman-Dutta
Psychologist, Clinical in Downers Grove, IL. Individual provider (NPI-1).
NPI number1245048834
StatusActive
Last updated in NPPESDec 27, 2024
Details
- NPI
- 1245048834
- Entity type
- Individual (NPI-1)
- Name
- Jenna Gidman-Dutta
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 27, 2024
- Certification date
- Dec 27, 2024
- Last updated
- Dec 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 071011335 | IL | Yes |
Practice location
1315 Butterfield Rd Ste 208Downers Grove, IL 60515-5602
Phone 630-441-4415
Mailing address
4315 Chelsea Manor CirAurora, IL 60504-3275
Phone 574-286-8375
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