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Individual

JENNIFER D'AGOSTINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2613 LAKEWOOD DR, DYER, IN 46311-2133
(626) 554-0408
Mailing address
2613 LAKEWOOD DR, DYER, IN 46311-2133
(626) 554-0408

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20043536A
IN
103TC0700X
Clinical Psychologist
Primary
20043536B
IN

Other

Enumeration date
08/10/2018
Last updated
12/17/2023
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