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Individual

DR. SHONDALE DELOACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6983
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6983

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
071.008906
IL
103TC0700X
Clinical Psychologist
Primary
3161-57
WI

Other

Enumeration date
05/22/2014
Last updated
10/14/2014
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