| NPI | 1730549981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEVYN PAIGE ANDERSON Owner 847-769-1873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008785) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |