Organization
MKP PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANASA K PERERA PHD (CLINICAL PSYCHOLOGIST)
(312) 515-7841
Entity
Organization
Contact information
Practice address
820 SHANNON LAKE CT, WESTMONT, IL 60559-2593
(312) 515-7841
Mailing address
820 SHANNON LAKE CT, WESTMONT, IL 60559-2593
(312) 515-7841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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