| NPI | 1568905032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY DANIEL DOAN Owner 224-200-7378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180010275) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |