| NPI | 1427254010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE FEDEN Clinical Psychologist 815-562-9353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004362) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-22 |