Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071.010241 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.010241 | IL |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1194244152 |
---|---|
Provider Name | Alexandria Grazia Salerno |
First Address | Oak Brook, IL 60523-1820 |
Second Address | Oak Brook, IL 60523-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2017 |
Last Update Date | 28/01/2020 |