Thidaporn Iamsutta, QMHP
Thidaporn Iamsutta, QMHP is a Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, Illinois. Practices as a sole proprietor. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
4753 N Broadway St Ste 700Chicago, IL 60640-4995
Phone: (773) 293-8430
Fax: (773) 728-4751
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Specialties & licences
| Mental Health Clinic/Center (Including Community Mental Health Center) (primary) | Taxonomy 261QM0801X |
|---|
Record details
| NPI number | 1972001709 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | QMHP |
| Sole proprietor | Yes |
| NPI enumerated | January 26, 2018 |
| Last updated in NPPES | January 26, 2018 |
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