| NPI | 1023500436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL JOHNSON Clinical Psychologist 773-844-2732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.009543) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |