Individual
DR. STACEY RENEE JOHNSON BELMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3166 N LINCOLN AVE, SUITE 217, CHICAGO, IL 60657-3133
(708) 406-9870
Mailing address
3166 N LINCOLN AVE, SUITE 217, CHICAGO, IL 60657-3133
(815) 501-5211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008266
IL
Other
Enumeration date
11/30/2011
Last updated
02/27/2014
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