| NPI | 1073849717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HUGH WALDRON Owner Psychologist 608-442-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 1774-057) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 913-123) |
| Enumeration Date | 2009-10-31 |
| Last Update Date | 2009-10-31 |