| NPI | 1780838185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN D WILKINSON President 618-580-8969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-000308) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 01773) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2015-02-09 |