| NPI | 1780739839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY B. WELLS Owner 815-895-1044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-004314) |
| Additional Taxonomies | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: IL 041-203519) |
| 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: IL 227-000946) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |