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Individual

ALEXANDRIA FOTOPOULOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7435 W MANITOBA DR, PALOS HEIGHTS, IL 60463-2017
(708) 912-6252
Mailing address
110 COLLINS ST, JOLIET, IL 60432-2942
(815) 727-6997
(815) 727-6996

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1835966
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103TS0200X
62
IL
Enumeration date
12/18/2018
Last updated
12/18/2018
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