Shiraz Tata PHD LLC
Shiraz Tata PHD LLC is a Clinical Psychologist in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2018.
- Licensed in
- IL
- In the registry since
- 2018
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
6072 Brynwood Dr Ste 107Rockford, IL 61114
Phone: (815) 519-2949
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Psychologist (primary) | Taxonomy 103TC0700X · Licence 071.04963 (IL) |
|---|
Record details
| NPI number | 1083109524 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shiraz Tata — Licensed Clinical Psychologist · (815) 519-2949 |
| Other names | Shiraz P. Tata |
| NPI enumerated | June 27, 2018 |
| Last updated in NPPES | August 1, 2018 |
| Mailing address | 6072 Brynwood Dr Ste 107, Rockford, IL 61114-5829 |
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