| NPI | 1366638389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT D HENDRICKSON Director 815-577-8970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-003587) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2013-04-10 |