| NPI | 1033806955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRISSA PANNUZZO Clinical Therapist/Owner 920-886-5946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-04-20 |