| NPI | 1912719121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUKIYA JOHNSON Licensed Clinical Pro. Counselor 815-715-3804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-23 |