Individual
DR. PONEH KAZEMSOLTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071010254
IL
103T00000X
Psychologist
32874
CA
103TB0200X
Cognitive & Behavioral Psychologist
071010254
IL
103TB0200X
Cognitive & Behavioral Psychologist
32874
CA
103TC0700X
Clinical Psychologist
Primary
071010254
IL
Other
Enumeration date
04/13/2022
Last updated
06/08/2022
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