| NPI | 1710239793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY MELISSAS MISKINIS Co Owner 309-764-4733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149014325) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180003695) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |