Individual
DR. SAMIRA GRACE DIDOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1503 WATERFORD PL, CHAMPAIGN, IL 61821-6971
(217) 369-7467
Mailing address
1503 WATERFORD PL, CHAMPAIGN, IL 61821-6971
(217) 369-7467
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.003660
IL
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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