Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 071.009923 | IL |
N | 103T00000X | Psychologist | 071.009923 | IL |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 071.009923 | IL |
NPI | 1124544648 |
---|---|
Provider Name | Dr. Stefanie Warning-Probst |
First Address | Wheaton, IL 60189-6733 |
Second Address | Park Ridge, IL 60068-1143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2017 |
Last Update Date | 09/01/2020 |