Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 2008925 | IL |
NPI | 1063079317 |
---|---|
Provider Name | Cathleen Martha Paullin |
First Address | Naperville, IL 60563-3310 |
Second Address | Darien, IL 60561-5333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2019 |
Last Update Date | 22/05/2019 |