Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071.009842 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.009842 | IL |
N | 103TS0200X | School Psychologist | IL |
NPI | 1023777042 |
---|---|
Provider Name | Dr. Sonia Cooper |
First Address | Lombard, IL 60148-2121 |
Second Address | Lombard, IL 60148-2121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2021 |
Last Update Date | 17/12/2021 |