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Individual

DR. BRANDI KRISTEN BOAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
417 N MAIN ST, SANDWICH, IL 60548-1569
(630) 649-2819
Mailing address
417 N MAIN ST, SANDWICH, IL 60548-1569
(630) 649-2819

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.007281
IL
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
Primary
071008926
IL
103TP0016X
Prescribing (Medical) Psychologist
074000002
IL

Other

Enumeration date
02/06/2008
Last updated
10/22/2020
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