Individual
DR. STEPHANIE BORJAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1422 W WILLOW ST, CHICAGO, IL 60642-8978
(773) 998-8500
Mailing address
1833 W ADDISON ST APT 3, CHICAGO, IL 60613-3502
(817) 937-3368
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071010393
IL
103T00000X
Psychologist
6301017737
MI
103TS0200X
School Psychologist
2384697
IL
Other
Enumeration date
06/15/2021
Last updated
08/31/2022
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