| NPI | 1619412160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN-MARIE MICHELLE SANDS Clinical Director 312-754-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2017-03-31 |