NPI | 1003340779 |
---|---|
Entity Type | Organization |
Authorized Contact | JASMINE ALEGRA TUDY Clinical Director 847-946-5105 |
Organization Subpart ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.000785) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.010922) |
Enumeration Date | 2017-04-19 |
Last Update Date | 2017-04-19 |