| NPI | 1033626932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY R DAVIS Psychotherapist/Clinical Sw 630-863-0408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.019648) |
| Additional Taxonomies | 1041S0200X Social Worker School |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-06 |