Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 071002727 | IL |
NPI | 1043365265 |
---|---|
Provider Name | Dr. Claire Stafford Brunegraff |
First Address | Glenview, IL 60026-1692 |
Second Address | Glenview, IL 60026-1692 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 18/02/2021 |