| NPI | 1093066599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH RUSSELL BAYER Owner/Family Therapist 847-231-3729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011633) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2023-10-11 |