| NPI | 1326244237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA L. MILLER Clinical Social Worker 217-351-8353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |