| NPI | 1457993032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH REYNERTSON Owner 217-615-2782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |