Organization
EDESSA MIRZAPOLOS, PSY.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDESSA MIRZAPOLOS PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(773) 387-6350
Entity
Organization
Contact information
Practice address
24012 W RENWICK RD STE 204, PLAINFIELD, IL 60544-8733
(773) 387-6350
Mailing address
13654 GOLDEN MEADOW DR, PLAINFIELD, IL 60544-9842
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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