| NPI | 1437667805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE THOMAS Operations Director 312-730-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009102) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149008520) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2023-11-10 |