| NPI | 1871117887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHELE DEANNE HAWBAKER Licensed Clinical Social Worker 217-972-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-10-30 |