NPI | 1184165383 |
---|---|
Doing Business As | GULF COAST PSYCH THERAPY GROUP |
Entity Type | Organization |
Authorized Contact | TERRY DORNAK Owner 312-781-2850 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009088) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
225700000X Massage Therapist | |
Enumeration Date | 2017-03-20 |
Last Update Date | 2023-05-15 |