| NPI | 1063878833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA RANSOM Clinical Psychologist/Owner 773-800-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071007126) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |