| NPI | 1003211426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GIBSON Licensed Clinical Psychologist 312-316-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007651) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |