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General NPI Number Information
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NPI Number | 1417772302
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Entity Type | Organization
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Legal Business Name | SOKO PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2329 N BOSWORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60614-3043
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Country | US
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Telephone | 813-777-3745
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Fax |
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Provider Business Mailing Address
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Address Line | 2329 N BOSWORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60614-3043
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Country | US
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Telephone | 813-777-3745
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JENNY SOKOLOWSKI
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Credential | PSY.D.
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Telephone | 813-777-3745
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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 |
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License Number State |
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