| NPI | 1144343625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARY WILSON Licensed Clinical Psychologist 815-601-3981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.007181) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2015-10-08 |