| NPI | 1992485122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN LYNELL JONES Liicense Clinical Social Worker 773-968-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2023-07-21 |