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NPI Profile for BOULES CLINICAL PSYCHOLOGY GROUP in BURR RIDGE, IL.
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prescribing (Medical) |
103TP0016X | 62 | Psychologist, Clinical | |
Community/Behavioral Health |
251S00000X | |||
Psychologist |
103T00000X | 62 | Psychologist, Clinical |
| NPI # | 1831703271 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/02/2020 | |
| Last updated | 02/08/2021 - About 5 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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BOULES CLINICAL PSYCHOLOGY GROUP
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BOULES CLINICAL PSYCHOLOGY GROUP