| NPI | 1639510167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELLE WHITEHEAD Owner 312-339-9832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2021-05-25 |