NPI | 1700499209 |
---|---|
Entity Type | Organization |
Authorized Contact | MIRNA BALLESTAS Clinical Psychologist 312-476-9588 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 103T00000X Psychologist |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TF0000X Psychologist, Family | |
103TH0004X Psychologist, Health | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2020-08-25 |
Last Update Date | 2020-08-25 |