| NPI | 1114145539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ANDREW GILBERTSON Co Director 262-240-9620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 1563) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-06-19 |