| NPI | 1972953099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY WILEY Mental Health Counselor 815-939-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180007352) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-10-27 |