Individual
DR. SAMANTHA C COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
917 W 18TH ST STE 203, CHICAGO, IL 60608-2400
(312) 620-5241
Mailing address
1516 W 18TH PL # 1R, CHICAGO, IL 60608-2802
(312) 420-4316
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010278
IL
Other
Enumeration date
04/14/2020
Last updated
07/12/2022
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