| Marvelous Minds, Inc | |
|
420 Pennsylvania Ave Ste 101 Glen Ellyn IL 60137-4427 | |
| (630) 474-4353 | |
| Not Available |
| Full Name | Marvelous Minds, Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 420 Pennsylvania Ave Ste 101, Glen Ellyn, Illinois |
| Authorized Official Name and Position | Kymberly Fay Larson (PRESIDENT) |
| Authorized Official Contact | 6304744353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marvelous Minds, Inc 420 Pennsylvania Ave Ste 101 Glen Ellyn IL 60137-4427 Ph: (630) 474-4353 | Marvelous Minds, Inc 420 Pennsylvania Ave Ste 101 Glen Ellyn IL 60137-4427 Ph: (630) 474-4353 |
| NPI Number | 1902319916 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 11/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902319916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071008752 (Illinois) | Primary |
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