| NPI | 1285348912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BAUTISTA Licensed Clinical Social Worker 773-480-3412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |