| NPI | 1265208425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA THRALL Licensed Clinical Social Worker 847-250-1994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2024-01-26 |