Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071.010107 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.010107 | IL |
NPI | 1003458720 |
---|---|
Provider Name | Lauren E Piper |
First Address | Villa Park, IL 60181-1729 |
Second Address | Chicago, IL 60611-3167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2019 |
Last Update Date | 14/10/2019 |