| NPI | 1720676679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA HANKERSON Clinical Psychologist 773-425-4857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-05-28 |