| NPI | 1003335290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY SUZANNE NEUKOMM Therapist/Owner 217-419-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.007459) |
| Additional Taxonomies | 261QM0801X (Licence: IL 180.007459) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |