| NPI | 1073722211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE MARIE HERZOG Clinical Director Psychologist 414-258-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |