| NPI | 1700415262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIERRA T PICKENS Psychotherapist 224-655-9742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2020-04-07 |