| NPI | 1639651235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNAFER ANN BRUCHAUSER SARNA Licensed Clinical Psychologist 815-401-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: IL 071009501) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |