| NPI | 1639120587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK TIVERS Owner 847-291-0468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-07-10 |