| NPI | 1023642725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD L REYNOLDS Psychotherapist/ Owner 920-728-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2021-03-23 |