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Organization
NEUROREHAB PSYCHOLOGY CONSULTANTS, LLC
Active
Organization
NEUROREHAB PSYCHOLOGY CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE M CICCONE-COUTRE PSYD (CLINICAL PSYCHOLOGIST/PRESIDENT)
(262) 412-7302
Entity
Organization
Contact information
Practice address
419 CENTER ST STE C, GRAYSLAKE, IL 60030-1645
(262) 412-7302
Mailing address
11314 E RIVIERA DR, SPRING GROVE, IL 60081-8146
(262) 412-7302
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
071.009251
IL
Other
Enumeration date
11/05/2017
Last updated
04/26/2018
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