| NPI | 1235533506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH CRANDALL Owner 217-329-1346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149015301) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166000861) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |