| NPI | 1568513034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY OUIDA HOUSTON Owner 708-349-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071004128) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071004128) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2016-06-12 |