| NPI | 1104336114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE BUSH Psychologist, Owner 312-806-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009612) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |