| NPI | 1821540428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZADEH GHAFFARI Clinical Psychologist 773-850-0294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008535) |
| Enumeration Date | 2016-10-29 |
| Last Update Date | 2020-06-01 |