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General NPI Number Information
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NPI Number | 1942503800
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Entity Type | Individual
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Provider Name | MS. BARBARA RICHARDSON
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 225 RICHMOND ST
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City | EVANSTON
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State | IL
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Zip | 60202-3639
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Country | US
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Telephone | 773-262-9625
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Fax |
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Provider Business Mailing Address
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Address Line | 7516 N CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60645-1571
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Country | US
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Telephone | 773-262-9625
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2064983
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 2064983
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 2064983
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 2064983
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 2064983
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2064983
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License Number State | IL
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