| Organization Name: | KB PSYCHOLOGICAL PRACTICE, PC |
| NPI Number: | 1063883395 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY L BAKER (PRESIDENT / OWNER) |
| Mailing Address: | 1821 Walden Office Sq Schaumburg |
| State: | IL US |
| Postal Code: | 601734295 |
| Phone Number: | 7089254523 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2015 |
| NPI Last Update Date: | 10/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071.00142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |