| NPI | 1154814713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY K ROTBLATT Owner 847-323-8189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008109) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149018766) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-09-25 |