Individual
PAVANAM SASHA VALUYEETHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2419 N ASHLAND AVE, CHICAGO, IL 60614-2020
(773) 755-1775
Mailing address
3925 N LINCOLN AVE APT 2B, CHICAGO, IL 60613-2428
(312) 520-2946
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.011192
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2022
Last updated
05/21/2024
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