NPI | 1386135754 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE DONSBACH Owner/Therapist 217-552-7774 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011001) |
Enumeration Date | 2018-05-22 |
Last Update Date | 2018-05-22 |