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Contact Information

MIND GUT THERAPY CENTER PLLC
1114 S WAIOLA AVE
LA GRANGE, IL60525-6627
 Phone: 312-576-5083
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health

103TH0004X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MIND GUT THERAPY CENTER PLLC · (Female)

NPI Number 1316511090
Status Active
Credentials
Entity Individual
Enumeration date 05/17/2021
Last updated 05/17/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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