| NPI | 1457720435 |
|---|---|
| Doing Business As | MINDOASIS |
| Entity Type | Organization |
| Authorized Contact | AMY MICHELLE FISCHER Lcsw/Owner 309-532-8455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149015544) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 149015544) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |