| NPI | 1083150635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHLEEN M MAHONY Mental Health Provider 815-527-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |