Organization
BESPOKE HEALING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAYNA FERN PINKSTON (FOUNDER)
(312) 690-3140
Entity
Organization
Contact information
Practice address
5153 N CLARK ST STE 306, CHICAGO, IL 60640-6850
(312) 690-3140
Mailing address
5153 N CLARK ST STE 306, CHICAGO, IL 60640-6850
(312) 690-3140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760931695
TYPE I NPI
—
Enumeration date
12/28/2021
Last updated
12/28/2021
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