| NPI | 1033382783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD TRAVIS Counselor 815-436-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180003461) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |