| NPI | 1568964575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS S CULBERT Sole Proprietor 312-467-1519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004224) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |