Individual
DR. MINDY WAXMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5860 ROCK DOVE CT, LONG GROVE, IL 60047-5062
(847) 507-5294
Mailing address
5860 ROCK DOVE CT, LONG GROVE, IL 60047-5062
(847) 507-5294
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009953
IL
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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