Providence Center for Psychological Services

NPI #1699109587 in Wheaton, Illinois

Provider Information

NPI Number: 1699109587
Entity Type: Organization
Organization Name: Providence Center for Psychological Services
Primary Specialty: Psychologist - Clinical
Enumeration Date: Aug 27, 2013
Last Updated: Aug 27, 2013

Practice Location

Address: 100 W ROOSEVELT RD # B-203
City: Wheaton
State: Illinois
ZIP Code: 60187-5260
Phone: (630) 221-0600

Authorized Official

Name: DR. KEENA PEEK, PSY.D.
Title: OWNER/PSYCHOLOGIST
Phone: (630) 221-0600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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