| NPI | 1225260458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA GIDNEY THOMPSON Psychologist 773-879-8272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007131) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |