| NPI | 1366182552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHAUNA L WATERS Owner 773-524-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-03-29 |