Individual
JENNIFER MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S., NCSP
Contact information
Practice address
2031 SHERIDAN RD, HIGHLAND PARK, IL 60035-2401
(224) 765-3300
Mailing address
6141 N KEATING AVE, CHICAGO, IL 60646-4903
(773) 427-0794
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1842735
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1842735
IL STATE BOARD OF ED - PROFESSIONAL EDUCATOR LICENSE
IL
Enumeration date
01/02/2018
Last updated
01/02/2018
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