| NPI | 1235990698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L FONSECA Mental Health Therapist 920-367-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-03-14 |