| NPI | 1154634632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN AUGUSTYN Counselor 618-251-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180006255) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |