| NPI | 1619686557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONE VERSE Director 773-619-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 251S00000X | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2022-11-18 |