| NPI | 1164568879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA L SCHWEFEL MASSIE Executive Director 920-887-8751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 1018) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |