NPI | 1033867288 |
---|---|
Entity Type | Organization |
Authorized Contact | DURRELL SHEPPARD Owner 773-450-8043 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-03-16 |
Last Update Date | 2022-03-16 |