| NPI | 1891025995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MAREK-MCKILLOP Therapist 708-309-0915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.006796) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 180.006796) |
| 103K00000X Behavior Analyst (Licence: IL 180.006796) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |