| NPI | 1174857312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN KNUTZEN Clinical Social Worker 715-281-1541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 625-123) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2010-12-21 |