Individual
MARY J IFFERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCSP
Contact information
Practice address
130 N HAZELTON AVE, WHEATON, IL 60187-4550
(630) 682-2474
(630) 462-1914
Mailing address
130 N HAZELTON AVE, WHEATON, IL 60187-4550
(630) 682-2474
(630) 462-1914
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
170220
IL
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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