| NPI | 1548976244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA MARIE CORIA-MACIAS Licensed Clinical Psychologist 773-365-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-06-04 |