| NPI | 1689926487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M GUY Director 217-347-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011337) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.006036) |
| 101YP2500X Counselor, Professional (Licence: IL 180000748) | |
| 101YP2500X Counselor, Professional (Licence: IL 180002037) | |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2013-01-28 |