Individual
KATHLEEN MARIE NUGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
60 REVERE DR, SUITE 100, NORTHBROOK, IL 60062-1563
(224) 306-1879
Mailing address
612 OUILMETTE LN, WILMETTE, IL 60091-2316
(847) 853-9413
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071007637
IL
103T00000X
Psychologist
071007637
IL
103TB0200X
Cognitive & Behavioral Psychologist
071007637
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071007637
IL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
071007637
IL
Other
Enumeration date
11/04/2009
Last updated
10/16/2013
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