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General NPI Number Information
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NPI Number | 1710511514
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Entity Type | Organization
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Legal Business Name | KIRSTEN T SVEJDA, PSYD, LLC
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 101 N MARION ST STE 202
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City | OAK PARK
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State | IL
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Zip | 60301-1023
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Country | US
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Telephone | 312-208-9457
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Fax |
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Provider Business Mailing Address
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Address Line | 325 S CUYLER AVE
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City | OAK PARK
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State | IL
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Zip | 60302-3515
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Country | US
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Telephone | 312-208-9457
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. KIRSTEN TESNAR SVEJDA
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Credential | PSYD
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Telephone | 312-208-9457
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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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