| NPI | 1861427387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWNMARIE WAGNER Counselor 708-261-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-004020) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |