Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 071.008040 | IL |
NPI | 1053614784 |
---|---|
Provider Name | Glen J Veed |
First Address | Naperville, IL 60563-2388 |
Second Address | Naperville, IL 60563-2388 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2010 |
Last Update Date | 06/09/2013 |