Provider Demographics
NPI:1609184803
Name:MIRSKY, INNA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:MIRSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 ERSKINE RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-1613
Mailing Address - Country:US
Mailing Address - Phone:815-904-3018
Mailing Address - Fax:
Practice Address - Street 1:2509 ERSKINE RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-1613
Practice Address - Country:US
Practice Address - Phone:815-904-3018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist