| NPI | 1215879044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL MICHELLE FOWLER Licensed Professional Counselor 414-617-3470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-04-09 |
| Last Update Date | 2026-08-13 |