| NPI | 1528118072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN ISRAELSOHN Owner 708-848-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-007781) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-09-03 |