| NPI | 1003580663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY GRIFFITH Professional Counselor/Therapist 224-349-2594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2022-06-13 |