NPI | 1003311556 |
---|---|
Entity Type | Organization |
Authorized Contact | CAREY SORENSON Owner 920-903-8841 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 3407-57) |
Enumeration Date | 2018-03-27 |
Last Update Date | 2024-04-18 |