| NPI | 1205154762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID COLOMBATTO Clinical Psychologist 312-859-6512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005566) |
| Enumeration Date | 2010-05-08 |
| Last Update Date | 2010-12-03 |