| NPI | 1407477052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MORRIS Owner 224-760-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TH0004X Psychologist, Health | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2023-02-16 |