| NPI | 1669011060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG MARTIN CFO 815-603-8637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-02 |