| NPI | 1669142758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON POPPY Licensed Clinical Psychologist Owne 309-529-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-09-20 |