| NPI | 1861700544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BLAKE SUTH President 773-718-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006431) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |