| NPI | 1497556286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE G. YOUNG Licensed Clinical Professional Coun 309-202-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Enumeration Date | 2025-03-19 |
| Last Update Date | 2025-03-19 |