NPI | 1912499351 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDRA DERKS Owner/Psychotherapist 847-708-4192 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5616-125) |
Enumeration Date | 2018-06-01 |
Last Update Date | 2018-06-01 |