| NPI | 1538636139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TICHIYA MAXEY Licensed Clinical Social Worker 708-288-2656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |