| NPI | 1700273976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE MARION MARTIN Director 847-624-2776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166000697) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |