| NPI | 1134577133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI ALLISON BRIN Clinical Psychologist 262-236-6693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3346-57) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-07-28 |