| NPI | 1821431628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE LAWRENCE Therapist 571-421-9842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.008522) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |