| NPI | 1538561691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL APPLEGATE Co Owner/Counselor 217-402-4071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.000861) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.009838) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.009275) | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2016-05-06 |