Organization
DONNA MARINO, PSY.D., LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARINO PSY.D. (OWNER)
(773) 882-0373
Entity
Organization
Contact information
Practice address
1101 LAKE ST, SUITE 310, OAK PARK, IL 60301-1085
(773) 882-0373
(708) 524-8758
Mailing address
P.O. BOX 613, CHANNAHON, IL 60410-0613
(815) 521-1889
(815) 521-1889
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006816
IL
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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