| NPI | 1942678453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIE FULTZ Therapist 773-332-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009061) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |