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General NPI Number Information
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NPI Number | 1528203007
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Entity Type | Organization
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Legal Business Name | MARY ENGLUND, PSYD., PLLC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 378 COLONIAL CIR
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City | GENEVA
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State | IL
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Zip | 60134-3639
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Country | US
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Telephone | 630-639-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 25 N RIVER LN STE 25485
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City | GENEVA
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State | IL
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Zip | 60134-2263
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Country | US
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Telephone | 630-639-2777
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MARY ENGLUND
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Credential | PSYD.
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Telephone | 630-639-2777
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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 | IL
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