| NPI | 1023323045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L FREEZE Practice Manager 219-926-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071003832) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2011-02-14 |