| NPI | 1467897512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN K CLEMENS Owner 224-207-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.007572) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2013-05-02 |