Individual
MIKI KOYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
333 N MICHIGAN AVE STE 2400, CHICAGO, IL 60601-4040
(773) 609-0361
Mailing address
333 N MICHIGAN AVE STE 2400, CHICAGO, IL 60601-4040
(773) 609-0361
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008355
IL
103TC1900X
Counseling Psychologist
071008355
IL
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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