| NPI | 1821306549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA MCKINNEY Clinical Psychologist 847-791-2851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.007472) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071.007795) |
| 1041C0700X Social Worker Clinical (Licence: IL 149007413) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |