| NPI | 1053713917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CATHERINE KNUTSON JAMES Owner 779-423-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.011881) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |