| NPI | 1063066629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY TRUSKY COO 312-569-0820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |