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General NPI Number Information
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NPI Number | 1043999816
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Entity Type | Organization
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Legal Business Name | VIANOVA PSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 412 S. 2ND ST.
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City | ST. CHARLES
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State | IL
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Zip | 60174-2819
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Country | US
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Telephone | 630-492-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 412 S. 2ND ST.
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City | ST. CHARLES
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State | IL
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Zip | 60174-2819
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Country | US
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Telephone | 630-492-0052
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. JOCELYN DROEGE
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Credential | PH.D.
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Telephone | 630-492-0052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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