Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 2018493 | IL |
NPI | 1013429935 |
---|---|
Provider Name | Yazmin E Cintron |
First Address | Chicago, IL 60612-2055 |
Second Address | Chicago, IL 60612-2055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2017 |
Last Update Date | 01/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018493 | ILLINOIS STATE BOARD OF EDUCATION (01) | IL |