| NPI | 1891187514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA K OLSON Licensed Clinical Social Worker 815-871-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149004808) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |