| NPI | 1134671910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ANN HICKS Psychotherapist 815-751-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 76385) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |