| NPI | 1104012244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI CHRISTINE GEBHARD Psychologist, Director 414-407-6664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2028) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2028) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: WI 2028) | |
| 103TH0004X Psychologist Health (Licence: WI 2028) | |
| Enumeration Date | 2007-09-22 |
| Last Update Date | 2007-09-22 |