| NPI | 1013342732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY RJ BELMONT Clinical Psychologist 708-406-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008266) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2014-01-28 |