Organization
BRIGHT STAR COMMUNITY OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA LANGLEY PSY.D. (CLINICAL SUPERVISOR)
(309) 645-5445
Entity
Organization
Contact information
Practice address
4518 S COTTAGE GROVE AVE, CHICAGO, IL 60653-4395
(773) 373-5220
(312) 982-2566
Mailing address
3473 S KING DR, SUITE 334, CHICAGO, IL 60616-4108
(773) 373-5220
(312) 982-2566
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.008564
IL
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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