| NPI | 1417070152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEEN BERRIOS Account Manager 847-770-6088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071005762) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071005762) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071005762) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2011-09-22 |