| NPI | 1386002590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEAJUANIS MALENA Owner 708-794-6461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008853) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |