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General NPI Number Information
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NPI Number | 1285127928
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Entity Type | Individual
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Provider Name | CARLY FLANNIGAN ED.S., NCSP
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Gender | Female
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 855 E PALATINE RD STE 250
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City | PALATINE
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State | IL
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Zip | 60074-5500
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Country | US
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Telephone | 847-504-9521
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Fax |
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Provider Business Mailing Address
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Address Line | 124 W COLFAX ST UNIT 508
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City | PALATINE
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State | IL
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Zip | 60067-5029
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Country | US
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Telephone | 847-302-5993
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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 | 2052204
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License Number State | IL
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