Organization
CENTER FOR GRIEF AND TRAUMATIC LOSS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN L. BOTKIN PSY.D. (DIRECTOR)
(847) 680-0279
Entity
Organization
Contact information
Practice address
1144 HARMS AVE, LIBERTYVILLE, IL 60048-2524
(847) 680-0279
Mailing address
1144 HARMS AVE, LIBERTYVILLE, IL 60048-2524
(847) 680-0279
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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