| NPI | 1104053701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSONNA SUE COMERS Owner 920-929-9140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 7003-123) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 29-036) |
| 103TC0700X Psychologist Clinical (Licence: WI 2270-057) | |
| 1041C0700X Social Worker Clinical (Licence: WI 7209-123) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |