| NPI | 1386903565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A STANTON Psychotherapist 773-320-5841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149010854) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-06-18 |