| NPI | 1083072227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA L LALLISH Licensed Clinical Social Worker 618-780-5256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.016663) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |