| NPI | 1720866619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIEL FERGUSON Licensed Clinical Psychologist 312-529-0616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |