| NPI | 1386123818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE STRYKER Clinical Social Worker 779-800-5859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149019167) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-07 |