NPI | 1093238305 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMIE CHOPP Owner 815-274-7118 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.010248) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32921) |
Enumeration Date | 2017-07-18 |
Last Update Date | 2017-07-18 |