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General NPI Number Information
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NPI Number | 1124652185
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Entity Type | Individual
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Provider Name | SOFFIYA A SIDDIQUI
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Gender | Female
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 3124 TREESDALE CT
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City | NAPERVILLE
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State | IL
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Zip | 60564-4609
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Country | US
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Telephone | 847-323-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 3124 TREESDALE CT
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City | NAPERVILLE
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State | IL
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Zip | 60564-4609
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Country | US
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Telephone | 847-323-0509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State | IL
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