| NPI | 1386821551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE ANITA FULLILOVE Owner/Psychologist 312-236-1498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 060005603) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |