| NPI | 1225270614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WAGNER Office Manager 217-836-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180002534) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |