| NPI | 1942555347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BLUMBERG Psychotherapist 773-251-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180007166) |
| Enumeration Date | 2012-07-22 |
| Last Update Date | 2018-04-24 |