Individual
DR. SELMA STAINBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1105 W PARK AVE, SUITE 2, LIBERTYVILLE, IL 60048-2567
(847) 362-5601
(847) 362-5611
Mailing address
1105 W PARK AVE, SUITE 2, LIBERTYVILLE, IL 60048-2567
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007839
IL
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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