| NPI | 1588011027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA MARTINEZ Licensed Clinical Social Worker 773-818-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149013793) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178007869) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-07-11 |