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General NPI Number Information
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NPI Number | 1801299656
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Entity Type | Organization
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Legal Business Name | ALIGNED MIND, PC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 3586 WETLANDS CT
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City | ELGIN
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State | IL
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Zip | 60124-5725
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Country | US
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Telephone | 630-217-7602
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Fax | 847-695-1334
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Provider Business Mailing Address
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Address Line | 3586 WETLANDS CT
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City | ELGIN
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State | IL
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Zip | 60124-5725
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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 | PRESIDENT/CLINICAL PSYCHOLOGIST
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Name | DR. LORA ANN KEIPPER
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Credential | PSY.D.
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Telephone | 630-217-7602
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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 | 071008779
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License Number State | IL
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