Organization
S. C. VALESSARES, PSY.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CHRISTINE VALESSARES PSY.D. (PRESIDENT)
(630) 881-7601
Entity
Organization
Contact information
Practice address
3 SQUIRE LN, ST CHARLES, IL 60174-1413
(630) 881-7601
(630) 513-6839
Mailing address
3 SQUIRE LN, ST CHARLES, IL 60174-1413
(630) 881-7601
(630) 513-6839
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071-006810
IL
103TC0700X
Clinical Psychologist
071-006810
IL
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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