Individual
DR. BRIAN RAMON HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
Mailing address
527 S CUYLER AVE, APT. 1, OAK PARK, IL 60304-1502
(708) 232-3724
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008646
IL
183700000X
Pharmacy Technician
049144667
IL
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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