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General NPI Number Information
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NPI Number | 1821621962
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Entity Type | Organization
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Legal Business Name | JENNIFER DIAMOND PHD, PLLC
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 939 W NORTH AVE STE 750
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City | CHICAGO
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State | IL
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Zip | 60642-7142
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Country | US
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Telephone | 262-885-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 910 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60614-4204
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Country | US
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Telephone | 312-802-9876
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JENNIFER DIAMOND
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Credential | PHD
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Telephone | 312-802-9876
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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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