| NPI | 1376089151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FARMER Clinical Psychologist 847-687-9313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60582444) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WA PY60560787) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2019-10-21 |