| NPI | 1134113038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD T POTTER-EFRON Owner 715-832-8432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1348) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-22 |