| NPI | 1245790088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JEAN KEANE Licensed Clinical/ Social Worker/ P 923-831-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-08-07 |