| NPI | 1407329063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAK-SENG LODRO Owner/Executive Director 312-810-6681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| 101YP2500X Counselor, Professional | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2023-11-24 |