Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071.008093 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.008093 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1023316254 |
---|---|
Provider Name | Dr. Brittany Lynn Lakin-Starr |
First Address | Chicago, IL 60657-6704 |
Second Address | Chicago, IL 60657-6704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2011 |
Last Update Date | 12/03/2011 |