Individual
DR. MARILYN M DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1306 WAUKEGAN RD, #201, GLENVIEW, IL 60025-3072
(847) 901-0909
(847) 901-0910
Mailing address
829 RIDGE TER, EVANSTON, IL 60201-2429
(847) 869-4270
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.004805
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
458586
NEUROFEEDBACK
IL
Enumeration date
04/10/2007
Last updated
08/09/2011
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