| NPI | 1699171207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA GREGOIRE Managing Member 773-771-8759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007702) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.015492) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |