| NPI | 1215368139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA KAY FABER Member/Manager 715-384-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 4342) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2014-04-01 |