| NPI | 1295004018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGETTE ELAIINE LEPAGE Owner/Provider 847-967-0952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2024-12-04 |