Individual
DR. JUSTIN LEITH BIRNHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5000 S 5TH AVE, HINES VA HOSPITAL, 116B, HINES, IL 60141-3030
(708) 935-1215
Mailing address
5000 S 5TH AVE, HINES VA HOSPITAL, 116B, HINES, IL 60141-3030
(708) 935-1215
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009337
IL
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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