Doctor Name: | FADIA DAMRA |
NPI Number: | 1982089587 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | |
Business Practice Address: | 23 Calendar Ct Ste 201 La Grange, IL - 605256327 |
Business Phone Number: | 7086179336 |
Business Fax Number: | 7089953806 |
Mailing Address: | 23 Calendar Ct Ste 207, LA GRANGE |
State: | IL |
Postal Code: | 605256327 |
Phone Number: | 7087455277 |
Fax Number: | 7087958610 |
NPI Enumeration Date: | 07/23/2015 |
NPI Last Update Date: | 07/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |