| NPI | 1407082936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L CORNETTE Clinical Psychologist 773-988-7144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 071007251) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |