Individual
JENNIFER MORIUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1645 W JACKSON BLVD STE 603, CHICAGO, IL 60612-2643
(312) 563-1791
Mailing address
1645 W JACKSON BLVD STE 603, CHICAGO, IL 60612-2643
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009928
IL
103TC0700X
Clinical Psychologist
2997
OR
Other
Enumeration date
09/07/2018
Last updated
12/09/2018
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