| NPI | 1952378192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD R LEGAN Clinical Psychologist 309-691-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 71002085) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2017-08-17 |