| NPI | 1023302767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LEIGH CARLSON Clinical Social Worker 414-963-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2706) |
| Enumeration Date | 2011-05-28 |
| Last Update Date | 2011-09-12 |