| NPI | 1063939163 |
|---|---|
| Former Legal Business Name | PRIVATE PRACTICE COUNSELING INC |
| Entity Type | Organization |
| Authorized Contact | JORGE M SANTAELLA Licensed Mental Health Counsel 773-218-9651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL MH16047) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-07-21 |