| NPI | 1871877621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE I HOOGSTRAAT Credentialing Specialist 217-552-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 149014837) |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2025-06-30 |