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General NPI Number Information
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NPI Number | 1487241857
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Entity Type | Organization
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Legal Business Name | TAKING CARE OF BUSINESS COUNSELING & COACHING SERVICES PLLC
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 2105 W 18TH ST
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City | CHICAGO
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State | IL
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Zip | 60608-1805
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Country | US
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Telephone | 773-522-1592
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60623-2901
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Country | US
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Telephone | 702-271-1985
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGY
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Name | ANDREA LYNN BOYD
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Credential | PH.D.
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Telephone | 702-271-1985
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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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