| NPI | 1013044478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARA RAE BAINUM President & Owner 217-228-1887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006947) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2006016141) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-08-11 |