Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 071.007944 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.007944 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 071.007944 | IL |
N | 103TP2701X | Group Psychotherapist |
NPI | 1154511103 |
---|---|
Provider Name | Ms. Heather Lynn Mcroberts |
First Address | Chicago, IL 60622-3540 |
Second Address | Oak Brook, IL 60523-1805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 09/09/2011 |