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General NPI Number Information
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NPI Number | 1982303004
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Entity Type | Individual
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Provider Name | KATHLEEN EDMIER PSYD, BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 444 N NORTHWEST HWY STE 320
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City | PARK RIDGE
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State | IL
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Zip | 60068-3277
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Country | US
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Telephone | 847-220-7298
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Fax |
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Provider Business Mailing Address
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Address Line | 444 N NORTHWEST HWY STE 320
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City | PARK RIDGE
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State | IL
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Zip | 60068-3277
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Country | US
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Telephone | 847-220-7298
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.022295
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-64250
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License Number State | IL
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