| NPI | 1205507407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA MARIE VEACH Licensed Clinical Psychologist 815-403-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-28 |