| NPI | 1295204766 |
|---|---|
| Other Name | BAKAHIA MADISON PSYB |
| Entity Type | Organization |
| Authorized Contact | BAKAHIA MADISON Vice President 773-807-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |