| NPI | 1689910804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY J MUNOZ Owner/President 309-453-3604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 180.007832) |
| Additional Taxonomies | 251S00000X (Licence: IL 149.015362) |
| Enumeration Date | 2012-12-15 |
| Last Update Date | 2022-07-21 |