| NPI | 1467179499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA GAGE Owner 773-255-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2022-11-04 |