| NPI | 1033569470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID V LADDEN Staff 331-442-4449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 1922406412) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |