| NPI | 1831526961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE BUSSMANN Owner/Lead Therapist 309-585-0241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005335) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178008398) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2014-07-14 |