| NPI | 1104855279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL J WESLEY Co Director 715-848-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: WI 2503) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |