| NPI | 1629450580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENELOPE J PRESTON Licensed Clinical Professional Coun 618-409-6062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.008861) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-07-09 |