| NPI | 1649785387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JOHNSON Licensed Clinical Psychologist 773-655-5329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008143) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |