Individual
MOLLY DESLANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
PSYD
Contact information
Practice address
1440 RENAISSANCE DR STE 320, PARK RIDGE, IL 60068-1471
(847) 759-9110
(224) 985-2119
Mailing address
1440 RENAISSANCE DR STE 320, PARK RIDGE, IL 60068-1471
(847) 759-9110
(224) 985-2119
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071011360
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071011360
STATE OF ILLINOIS
IL
Enumeration date
12/23/2024
Last updated
12/23/2024
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