| NPI | 1558497156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SIMONE GAINES Office Manager 773-782-6173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 036100047) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-10-28 |