| NPI | 1740964204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDESSA MIRZAPOLOS Licensed Clinical Psychologist 773-387-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-06-14 |