| NPI | 1164351417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA MACGILLIVRAY Co Owner 262-893-0769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2026-05-14 |
| Last Update Date | 2026-05-15 |