The Brain Clinic, LLC

NPI #1972117521 in Sandwich, Illinois

Provider Information

NPI Number: 1972117521
Entity Type: Organization
Organization Name: The Brain Clinic, LLC
Primary Specialty: Psychologist
Enumeration Date: Sep 1, 2020
Last Updated: Dec 7, 2020

Practice Location

Address: 417 N MAIN ST
City: Sandwich
State: Illinois
ZIP Code: 60548-1569
Phone: (630) 649-2819

Authorized Official

Name: DR. BRANDI KRISTEN BOAN, PSYD
Title: OWNER
Phone: (630) 649-2819

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Neuropsychologist	103G00000X
Psychologist - Prescribing (Medical) — Prescribing (Medical)	103TP0016X
Community/Behavioral Health	251S00000X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Psychologist	103T00000X	Primary

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