| NPI | 1033772058 |
|---|---|
| Doing Business As | DIFFERENT SHADES OF HEALING |
| Entity Type | Organization |
| Authorized Contact | NASTASSIA JACKSON Therapist/Owner 414-265-6156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |