| NPI | 1598024200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE J CRAWFORD Manager 312-388-4967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 036056639) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2016-06-10 |