| NPI | 1508213091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH COHN SRIVASTAVA Psychotherapist 773-480-5297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011049) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |