NPI | 1497067292 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY H. MACDONALD Owner 630-879-8164 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005595) |
Enumeration Date | 2010-07-08 |
Last Update Date | 2023-11-30 |