| NPI | 1497034706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CUBALA Clinical Psychologist 773-882-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071007681) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |