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 |