| NPI | 1689049199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LACASSE Clinical Psychologist 312-724-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009189) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |