| NPI | 1760266423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN ANNE LASLEY Owner 773-573-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-28 |