| NPI | 1154754547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE L BLACKMON Licensed Professional Counselor 773-934-5668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 180.007189) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |