| NPI | 1801497623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY M NELSON Clinical Social Work/Therapist 708-770-0814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2021-01-01 |