| NPI | 1053814848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILEE JOHNSON Owner 242-232-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.010891) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2023-12-13 |