| NPI | 1053009449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORICE PEARSON Mental Health Therapist 262-289-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |