| NPI | 1013538131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN E GINSKI Owner 815-999-5684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2021-03-15 |