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 |