| NPI | 1720341993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH SMITH HETHERINGTON Director 773-791-0469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.000557) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.003937) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |