Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | IL |
NPI | 1063921054 |
---|---|
Provider Name | Miss Maria Teresa Ramos |
First Address | Darien, IL 60561-4036 |
Second Address | Bolingbrook, IL 60440-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2017 |
Last Update Date | 22/09/2017 |