| NPI | 1124404447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE FOX President 837-363-0582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 149009105) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |