| NPI | 1467023069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN BENTON Owner 217-560-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2021-07-05 |