Individual
JOSE ANTONIO CENTENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1252 W BRYN MAWR AVE APT 2E, CHICAGO, IL 60660-0045
(312) 523-7314
Mailing address
1252 W BRYN MAWR AVE APT 2E, CHICAGO, IL 60660-0045
(312) 523-7314
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010216
IL
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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