| NPI | 1730727819 |
|---|---|
| Other Name | FORMER LEGAL BUSINESS NAME |
| Entity Type | Organization |
| Authorized Contact | SHAOXUAN WANG Therapist 708-277-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2020-01-09 |