NPI | 1225355902 |
---|---|
Entity Type | Organization |
Authorized Contact | DENNIS CLARK WEEDEN Co Owner 262-375-9225 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 432-123) |
Enumeration Date | 2010-04-21 |
Last Update Date | 2010-04-21 |