Individual
MISSY JEAN BUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4909 W DIVISION ST, CHICAGO, IL 60651-3161
(773) 921-7805
Mailing address
2030 N SEDGWICK ST, UNIT N, CHICAGO, IL 60614-4766
(773) 244-0373
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
71006608
IL
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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