| NPI | 1689958050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE MAXWELL President 773-316-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006622) |
| Additional Taxonomies | 251S00000X (Licence: IL 071-006622) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |