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Organization

OCCUPATIONAL CLINICAL PSYCHOLOGISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS P. LAVIN PH.D. (CLINICAL PSYCHOLOGIST)
(847) 256-6440
Entity
Organization

Contact information

Practice address
400 LINDEN AVE, WILMETTE, IL 60091-3606
(847) 256-6440
Mailing address
400 LINDEN AVE, WILMETTE, IL 60091-3606
(847) 256-6440

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
08/25/2006
Last updated
08/22/2020
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