| NPI | 1275665721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A. MYERS Owner 815-308-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC1900X Psychologist, Counseling | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2016-01-13 |