Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | ||
N | 103TC0700X | Clinical Psychologist | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
Y | 103TH0004X | Health Psychologist | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1386114122 |
---|---|
Provider Name | Cassandra Christine Kandah |
First Address | Chicago, IL 60647-1930 |
Second Address | Chicago, IL 60606-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2018 |
Last Update Date | 25/04/2019 |