Individual
MELINDA R. STOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
1747 W ROOSEVELT RD, 456 WRB, MC 275, CHICAGO, IL 60608-1264
(312) 996-0523
(312) 413-8950
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
071005858
IL
Other
Enumeration date
09/14/2006
Last updated
06/24/2008
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