NPI | 1790399319 |
---|---|
Entity Type | Organization |
Authorized Contact | GEORGIA ELLEN FLEMING Billing Specialist 847-608-8570 |
Organization Subpart ? | No |
Primary Taxonomy | 104100000X Social Worker |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YP2500X Counselor, Professional | |
103TC1900X Psychologist, Counseling | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2020-09-01 |
Last Update Date | 2020-09-01 |