| NPI | 1174913156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO BRILL Psychotherapist 414-906-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 3677123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 7969123) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |