| NPI | 1043051238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE JOHNSON Co Owner 815-557-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |