Individual
JANE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
1050 IVY HALL LN, BUFFALO GROVE, IL 60089-1333
(847) 459-4260
Mailing address
1050 IVY HALL LN, BUFFALO GROVE, IL 60089-1333
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
714773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
714773
PROFESSIONAL EDUCATOR LICENSE
IL
Enumeration date
11/15/2017
Last updated
11/15/2017
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