NPI | 1801993142 |
---|---|
Entity Type | Organization |
Authorized Contact | BRITTNEY BUTTERFIELD Billing Specialist 309-692-6622 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071-004483) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2023-09-25 |