Individual
DR. MANASA K PERERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
820 SHANNON LAKE CT, WESTMONT, IL 60559-2593
(312) 515-7841
Mailing address
820 SHANNON LAKE CT, WESTMONT, IL 60559-2593
(312) 515-7841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071.009262
IL
103TC0700X
Clinical Psychologist
Primary
071009262
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071009262
ILLINOIS LICENSURE FOR CLINICAL PSYCHOLOGIST
IL
Enumeration date
05/05/2016
Last updated
12/14/2022
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