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 |