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General NPI Number Information
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NPI Number | 1235774191
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Entity Type | Individual
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Provider Name | CORINA HERRERA
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Gender | Female
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 191 W 155TH PL
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City | HARVEY
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State | IL
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Zip | 60426-3413
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Country | US
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Telephone | 708-339-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 191 W 155TH PL
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City | HARVEY
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State | IL
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Zip | 60426-3413
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Country | US
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Telephone |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2317255
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License Number State | IL
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