| NPI | 1043860489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA MARQUEZ ROTH Owner 630-589-0131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |