| NPI | 1780120584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN J CAMPBELL Clinical Counselor 815-214-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.009612) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |