| NPI | 1912417304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE KRUSE Director/Psychotherapist 224-803-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.016662) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-01-09 |