Individual
DR. TETYANA KOSTYSHYNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LCPC, LSOE/TP
Contact information
Practice address
555 S RANDALL RD STE 204, ST CHARLES, IL 60174-5918
(312) 818-9300
(888) 488-2604
Mailing address
555 S RANDALL RD STE 204, ST CHARLES, IL 60174-5918
(312) 818-9300
(888) 488-2604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180009177
IL
103T00000X
Psychologist
3415 - 57
WI
103TC0700X
Clinical Psychologist
Primary
071.009432
IL
Other
Enumeration date
08/08/2016
Last updated
11/04/2024
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