| NPI | 1659804003 |
|---|---|
| Doing Business As | MOONLIGHTWELLBEING |
| Entity Type | Organization |
| Authorized Contact | ADAM LLOYD SHAFER President 708-537-9951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008760) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |