| NPI | 1992379234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PEREGUD-AKSIMENTYEVA Clinical Therapist 217-721-3263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-07-31 |