| NPI | 1659092625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODI HICKEY Owner/Therapist 815-210-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2023-11-28 |