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 |