| NPI | 1073831525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE FOULES Counselor 708-906-7912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.010964) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |