| NPI | 1063116002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSA RICHARDSON Licensed Clinical Psychologist 217-953-1343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-05-29 |