| NPI | 1366178444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WALSH Lcsw 708-620-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-12-07 |