| NPI | 1356713341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY ASHMUN Clinical Counselor Intern 773-791-8442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 2287) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |