| NPI | 1194068742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN L LIDBURY Owner/Provider 708-481-5466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.002670) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2013-04-02 |