| NPI | 1528243086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B. DUDGEON Clinical Psychologist 815-399-9303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071001993) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |