| NPI | 1710215454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN MARIE SIERRA Director 618-398-6552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.000561) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |