| NPI | 1104688365 |
|---|---|
| Doing Business As | DELTA CENTER OF WISCONSIN |
| Entity Type | Organization |
| Authorized Contact | LESLIE JOHNSON CEO 704-506-6267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-04-24 |