Individual
CARLA B BEATRICI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2160 S FIRST AVE, (15750 MARION DR., HOMER GLEN, IL. 60491), MAYWOOD, IL 60153
(708) 645-3400
(708) 645-3411
Mailing address
2160 S FIRST AVE, (15750 MARION DR., HOMER GLEN, IL. 60491), MAYWOOD, IL 60153
(708) 645-3400
(708) 645-3411
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
71005893
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71005893
—
IL
Enumeration date
02/24/2006
Last updated
06/22/2021
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