Individual
DR. KELLY LYNN LEMAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4043 N RAVENSWOOD AVE STE 302, CHICAGO, IL 60613-5683
(630) 277-9033
Mailing address
1831 W WARNER AVE APT 2, CHICAGO, IL 60613-1862
(574) 514-2347
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010781
IL
103TH0100X
Health Service Psychologist
200043270
IN
103TH0100X
Health Service Psychologist
5412
NC
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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