| NPI | 1205306115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI WIDUCH Executive Director 608-784-8125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2019-01-08 |