NPI | 1275616484 |
---|---|
Entity Type | Organization |
Authorized Contact | DELORES ODELL MCCOLLUM President 309-762-3931 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071003806) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2020-08-22 |