| NPI | 1346717147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M ASHLOCK Licensed Clinical Professional Coun 618-965-8030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |