| NPI | 1275733602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZETTE MARIE KOSNAR-TITTL Owner, CEO, Provider 920-884-2175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 4044-123) |
| 101YP2500X Counselor, Professional (Licence: WI 2376 125) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 4044 123) | |
| 106H00000X Marriage & Family Therapist (Licence: WI 489 124) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2023-10-16 |