| NPI | 1891200317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDRENA JOY DAVIS Licensed Clinical Social Worker 773-879-2274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149018258) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |