NPI | 1932648136 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLIE WILLET KRUCHKO President 630-778-1055 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071005578) |
Enumeration Date | 2017-02-21 |
Last Update Date | 2017-02-21 |