| NPI | 1770654816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KENNEDY GARDNER Clinical Psychologist 312-372-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071-004477) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2020-08-22 |