Individual
AMANDA MOULCHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 EAGLE WAY, LAKE VILLA, IL 60046-7477
(847) 395-9423
Mailing address
37285 N DEERPATH DR, LAKE VILLA, IL 60046-6796
(847) 404-0815
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1136070
IL
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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