| 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 |