| NPI | 1689333726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA K EISIN-BANAZEK Professional Counselor 773-967-9085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-16 |