Organization
IRINA PODOLSKY PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRINA PODOLSKY PSYD (OWNER)
(312) 320-5137
Entity
Organization
Contact information
Practice address
1623 W MAIN ST, FAIRFIELD, IL 62837-2343
(312) 320-5137
Mailing address
PO BOX 278, FAIRFIELD, IL 62837-0278
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
073.000074
IL
Other
Enumeration date
11/28/2017
Last updated
11/13/2018
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