| NPI | 1902134778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRUDENCE L GOURGUECHON President 773-878-8082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: IL 036062459) |
| Enumeration Date | 2009-12-06 |
| Last Update Date | 2009-12-06 |