| NPI | 1912748674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR ASHLEY PRELLBERG Owner 815-651-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-05 |