| NPI | 1730525148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE G PALACIO President 312-402-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071007375) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |