| NPI | 1467219154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDANA ELIZABETH BALLESTEROS Manager/Therapist 224-538-1819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-04-04 |