Individual
DR. JODI FOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5334 WILLIAMS DR, ROSCOE, IL 61073-7320
(224) 703-5595
Mailing address
13 CROSSVIEW CT, LAKE IN THE HILLS, IL 60156-5841
(224) 703-5595
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010162
IL
Other
Enumeration date
09/25/2012
Last updated
05/04/2020
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