| NPI | 1003168139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILSA HANSEN Professional Licensed Counselor 608-838-7931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 4572-125) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |