| NPI | 1104560036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ROBERT MARX Owner/Therapist 920-221-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |