| NPI | 1841589462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M REA Licensed Clinical Social Worker 708-996-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004882) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-02-03 |