NPI | 1801409974 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES DYERS President 815-941-3882 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2020-08-28 |
Last Update Date | 2020-08-28 |