| NPI | 1023640695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS RUDER Director 608-606-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical | |
| 225800000X Recreation Therapist | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |