| NPI | 1881455012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN ROSS Clinical Psychologist 312-210-0374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |