Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist |
NPI | 1215218839 |
---|---|
Provider Name | Anjuli Ramesh Amin |
First Address | Hines, IL 60141-3030 |
Second Address | Hines, IL 60141-3030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 09/09/2011 |