| NPI | 1225813793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BERTH Director 920-483-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2023-08-31 |