| NPI | 1396735361 |
|---|---|
| Former Legal Business Name | PSYCHOLOGY CENTER INC |
| Entity Type | Organization |
| Authorized Contact | JAMES T DAVENPORT Owner/Provider 708-974-4274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003666) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 060005211) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2015-01-28 |