| NPI | 1003340027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISSA BLAKE NOBLE Co Owner/President 773-677-7363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.007387) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |