Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1999827 | IL |
NPI | 1043727274 |
---|---|
Provider Name | Lindsey Rockwell |
First Address | Belvidere, IL 61008-6503 |
Second Address | Belvidere, IL 61008-6503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2018 |
Last Update Date | 09/01/2018 |