| NPI | 1538859079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON DOUGLAS Licensed Professional Counselor 309-706-4989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-07-03 |