| NPI | 1134787989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VAIL Owner 217-303-5331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |