| NPI | 1346361961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS LYBROOK TAUBERT President 773-248-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL 060-007678) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2025-10-01 |