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General NPI Number Information
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NPI Number | 1205278041
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Entity Type | Organization
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Legal Business Name | TAPIA PSYCHOLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 1520 N DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60622-1967
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Country | US
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Telephone | 630-241-1495
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Fax | 630-241-1543
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Provider Business Mailing Address
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Address Line | 8015 AARON LN
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City | JOLIET
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State | IL
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Zip | 60431-8480
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Country | US
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Telephone | 773-876-4122
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Fax | 630-241-1543
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Authorized Official
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Title or Position | OWNER
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Name | DR. NNEKA SARAN JONES
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Credential | PSY.D
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Telephone | 630-241-1495
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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 | 071007558
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License Number State | IL
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