| NPI | 1518502251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY STONE Owner 708-906-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 102L00000X Psychoanalyst | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-01-29 |