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General NPI Number Information
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NPI Number | 1265990014
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY RESOURCES, INC.
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST STE 1201
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City | CHICAGO
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State | IL
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Zip | 60602-1868
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Country | US
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Telephone | 312-984-0417
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Fax | 312-456-3036
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Provider Business Mailing Address
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Address Line | 25 E WASHINGTON ST STE 1201
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City | CHICAGO
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State | IL
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Zip | 60602-1868
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Country | US
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Telephone | 312-984-0417
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Fax | 312-456-3036
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DANIEL O'GRADY, PH.D.
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Credential | PH.D.
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Telephone | 312-984-0417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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