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General NPI Number Information
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NPI Number | 1841901675
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Entity Type | Organization
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Legal Business Name | JENNIFER MORALES PSYD PLLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 5 REVERE DR STE 200
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City | NORTHBROOK
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State | IL
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Zip | 60062-8000
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Country | US
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Telephone | 847-220-4602
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Fax | 773-496-7155
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Provider Business Mailing Address
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Address Line | 6787 N JEAN AVE
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City | CHICAGO
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State | IL
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Zip | 60646-1352
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Country | US
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Telephone | 847-220-4602
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Fax | 773-496-7155
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | JENNIFER MORALES
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Credential | PSYD
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Telephone | 847-220-4602
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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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