| NPI | 1013309475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA ROCHA Office Manager 847-577-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005462) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180009233) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071005864) | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-26 |