| NPI | 1558470419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL VINCENT Owner 309-797-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-01-26 |