| NPI | 1912030735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARVEY MARTIN Psychologist 708-960-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071006721) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2009-12-10 |