| NPI | 1336616119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ELIZABETH PLONKA Licensed Clinical Psychologist 708-762-3531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |