| NPI | 1306992938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARNEY M BRUZETTI Chief Fiscal Officer 217-544-0388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-00384) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-004929) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149 010270) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149 000796) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 166.000297) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |