Individual
DR. THERESE CELINE SULENTICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1671411
BLUE CROSS AND BLUE SHIEL
IL
01
—
35824
MAGELLAN HEALTH PROVIDER
IL
01
—
8662099320
UNITED BEHAVIORAL HEALTH
IL
Enumeration date
10/05/2006
Last updated
07/08/2007
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