| NPI | 1194150409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA JAMAL JACKSON Clinical Psychologist/President 847-977-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016903) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |