| NPI | 1003447673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTRELLA GONZALEZ Billing And Intake Supervisor 312-578-9990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2022-02-17 |