| NPI | 1962924829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SMITH President 773-985-8746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.009490) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |