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General NPI Number Information
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NPI Number | 1689459018
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Entity Type | Individual
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Provider Name | LINDSAY SOTO PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 1020 MILWAUKEE AVE STE 126
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City | DEERFIELD
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State | IL
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Zip | 60015-3561
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Country | US
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Telephone | 847-807-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 CENTRAL ST APT 3E
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City | EVANSTON
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State | IL
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Zip | 60201-1354
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Country | US
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Telephone |
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 071011002
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License Number State | IL
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