Individual
LAURA GUMBINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
144 N COURT ST, DIXON, IL 61021-1224
(815) 288-1905
Mailing address
1914 W LEOPARD DR, DIXON, IL 61021-9100
(847) 715-6823
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071011021
IL
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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