| NPI | 1598433898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MEDALIE CEO 224-572-8470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2023-03-27 |