Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | IL |
NPI | 1013091750 |
---|---|
Provider Name | Dawn Renee Levitan |
First Address | Crystal Lake, IL 60012-2079 |
Second Address | Crystal Lake, IL 60014-6266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |