| NPI | 1003637794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE-MARIE FOTECK MAKONGHO Licensed Professional Counselor 608-504-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |