| NPI | 1619860434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY BIZEAU Licensed Clinician Social Worker 224-578-9250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2026-03-03 |