| NPI | 1043704638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA K SANDORA Licensed Clinical Social Worker 414-533-7584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8831-123) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |