Individual
DR. VIJAYALAKSHMI SUSARLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
2628 83RD ST, DARIEN, IL 60561-1661
(630) 246-6810
(630) 246-6809
Mailing address
632 CONESTOGA RD, NAPERVILLE, IL 60563-2491
(630) 975-1610
(630) 246-6809
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071005075
IL
Other
Enumeration date
08/30/2006
Last updated
12/11/2013
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