| NPI | 1881014496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA R BRADDEN Marriage And Family Therapist 773-998-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 166000731) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |