| NPI | 1861070773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HENRY VAN SLEE Co Owner/Psychotherapist 815-272-3476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2021-04-27 |