| NPI | 1669898839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMNEY ALLANE PAYNE Secretry/Treasurer 312-720-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-002625) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |