| NPI | 1508632712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY REYNOSO Counselor 773-307-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |