| NPI | 1659851723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN FLORES President 773-688-9074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009238) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |