Doctor Name: | DR. KATHRYN SMART MURSAU |
NPI Number: | 1164546735 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | |
Business Practice Address: | 977 Lakeview Pkwy Suite 102 Vernon Hills, IL - 600611400 |
Business Phone Number: | 8476800755 |
Business Fax Number: | |
Mailing Address: | 1041 Popes Creek Cir, GRAYSLAKE |
State: | IL |
Postal Code: | 600301140 |
Phone Number: | 8475434480 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |