Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | IL | |
Y | 103T00000X | Psychologist | IL |
NPI | 1003018268 |
---|---|
Provider Name | Dr. Pamela Daley |
First Address | Forest Park, IL 60130-1332 |
Second Address | Chicago, IL 60602-3402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 08/07/2007 |