NPI | 1528432119 |
---|---|
Entity Type | Organization |
Authorized Contact | LEIGH GRANNAN Clinic Director 217-588-7622 |
Organization Subpart ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101YP2500X Counselor Professional |
103TC0700X Psychologist Clinical | |
225XP0200X Occupational Therapist Pediatrics | |
235Z00000X Speech-Language Pathologist | |
Enumeration Date | 2015-11-19 |
Last Update Date | 2015-11-19 |