| NPI | 1245425354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M RENNIE Owner 414-803-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 2478) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2478) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 2478) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |