| NPI | 1639623044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENICE MARIE MOCK Director/Owner 815-758-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149013457) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |