| NPI | 1346750270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN STARKS Owner 708-689-9568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.014692) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.009523) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |