NPI | 1427021393 |
---|---|
Entity Type | Organization |
Authorized Contact | JANE VELEZ Owner, Clinical Psychologist 309-689-6700 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005320) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: IL 14987) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2012-04-12 |