| NPI | 1356692305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL E. BRICKER Co Director 773-428-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007755) |
| Enumeration Date | 2012-09-29 |
| Last Update Date | 2012-09-29 |