| NPI | 1033007380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEIGH LYNN CORSON Lcpc 217-577-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |