| NPI | 1205979168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE SUSAN O'CONNOR Director 715-832-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1203) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2018-01-16 |