| NPI | 1821494584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA BOURRET Co Owner 815-409-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2017-11-03 |