| NPI | 1437385028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON A. WIERENGA Manager 708-254-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-005274) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-006390) |
| 101YP2500X Counselor, Professional (Licence: IL 180-006728) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-003846) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2009-06-09 |